面中部双层皮肤软组织提紧术

目的：为了改善面中部皮肤、软组织松驰，方法：通过分离面中部皮下组织和颧弓韧带组织，将颧部软组织向外上方复位并固定于颧骨骨膜上。结果：通过手术可有效地恢复中部松驰下垂的组织平化了鼻唇沟的深度。结论：应用面中部双层皮肤软组织是紧术，通过双层提紧固定，可以达到永久悬吊的作用。     

面中部双层皮肤软组织提紧术

目的　为了改善面中部皮肤、软组织松弛。方法　通过分离面中部皮下组织和颧弓韧带组织 ,将颧部软组织向外上方复位并固定于颧骨骨膜上。结果　通过手术可有效地恢复面中部松弛下垂的组织平化了鼻唇沟的深度。结论　应用面中部双层皮肤软组织提紧术 ,通过双层提紧固定 ,可以达到永久悬吊的作用。     

皮肤软组织并联扩张术修复面中部瘢痕

目的寻求修复面中部瘢痕的新方法。方法15例面中部瘢痕患者于Ⅰ期手术时,在其颌面、颈、耳后部皮肤软组织下并联埋置2个扩张器,待扩张至有足够的“额外”皮肤软组织后,施行Ⅱ期手术,旋转并推进扩张皮瓣以修复面中部瘢痕。结果本组患者术后切口相对隐蔽,修复部位皮肤颜色、质地等符合要求,面部外观得到明显改善。结论颌面、颈、耳后部皮肤软组织并联扩张术是一种修复面中部瘢痕的较好方法,有一定的临床应用价值。     

除皱术的实质是提紧术

笔者之所以拟“除皱术的实质是提紧术”的文题,是因为面颈部老化的主要表现一是皱纹、二是松垂。除皱手术只能去除少数的动力性皱纹,如额横纹和眉间纵纹。但尚有许多面颈部的皱纹，以迄今为止的除皱技术去解决是无显效甚至是无效的,如鱼尾纹、鼻唇沟、颈横纹、口周放射状皱纹。然而，对于多数老化性松垂的求美者,采用经典的术式是可以解决的,如眉与上睑的松垂、颧颊部的松垂、颌缘前段的堆积、重颏畸形等。拟此文题的另一个因素是因为松垂对面颈部老化的影响大于皱纹的影响，更何况某些皱纹的产生是松垂的继发产物。相信许多同道会同意以上的观点。     

改良SMAS分离悬吊面中部除皱术

为了提高面中部除皱手术疗效和减少手术创伤，根据耳前部ＳＭＡＳ相对与下方组织紧密相加的解剖特点，将ＳＭＡＳ分为固定的和移动的两部分，提出于剥离移动ＳＭＡＳ后悬吊于固定的ＳＭＡＳ上的改良ＳＭＡＳ分离悬吊面中部除皱方法，以减少手术并发症，自１９９５年１至１１月经斯德拉斯堡欧洲美容整形诊所３１例的实践，均取得满意疗效。认为，移动的ＳＭＡＳ是应用ＳＭＡＳ悬吊除皱术的关键组织结构，固定的ＳＭＡＳ是手术设计必要     

埋线悬吊法面颊及眶外侧软组织松垂提紧256例

面部除皱术发展至今，其技术已经日趋完善，术后远期效果确实可靠，已毋庸质疑。但此术式需要全身麻醉，费用较高；一旦损伤重要神经或血管，后果严重，且术后恢复时间长，切口痕迹明显，甚至遗留较重的瘢痕。埋线悬吊法面颊部提紧术，操作简单，无须剪发，创伤轻微，术后无明显的疼痛及切口痕迹等。并且损伤面部神经、血管的可能性极小。自2003年12月至2005年5月，笔者对256例患者采用埋线悬吊法面颊部提紧或眶外侧部提紧术，效果满意。     

锯齿线面部皮肤微创美容提紧术

目的 介绍一种面部微创美容术--锯齿线行面部皮肤松弛下垂提紧术的方法.方法 首先于面部设计并标记锯齿线的走行,应用一次性带针芯穿刺针行锯齿线埋置前的导引.以30°角行面部皮肤穿刺到SMAS层,拔出穿刺针的针芯,导入锯齿线,充分钩挂SMAS层后埋置.埋置的数量为6～12根.结果 本组患者52例,其中双侧不对称者3例,经对较松弛的一侧增加埋置锯齿线1、2根后满意;针孔有红肿反应者2例,取出导入时带入针孔的毛发后缓解;埋置的走行处有点状凹陷者2例,用注射针行皮下剥离后好转.术后随访52例患者6～12个月,松垂的皮肤均有效提紧,且效果满意.结论 微创法锯齿线SMAS层埋置皮肤提紧术,可使松垂的面部皮肤有效地提升、提紧,而正确的设计、准确的操作方法及埋置锯齿线的数量,是术后效果和维持时间的关键.     

内镜额颞部上提与面中下部多层次剥离除皱术

自１９９５年８月以来,我们对１８例面部老化明显者,采用内窥镜技术额颞部上提与面中部行广泛多层次剥离悬吊术,取得良好效果。１手术方法１．１麻醉及切口设计 均在全麻下,于额部发际后２～２．５ ｃｍ,在正中及左右颞线上各设计长２ｃｍ纵向小切口,耳前切口紧邻耳轮上脚、耳屏及耳垂。１．２额颞部（面上部）剥离 额颞部切口深至帽状腱膜下层,盲视下钝性剥离顶枕部,直到枕骨粗隆;前方剥离额部至眶缘上３ ｃｍ,向左右侧掀起颞部头皮,到达颧弓上２ ｃｍ处。将内窥镜从其中１个切口放至眶缘上,用内窥镜剥离子在内窥镜监视下充分…     

悬吊预控张力方法在面部除皱手术中的应用

目的:在面部除皱术中,探索一种可降低伤口闭合张力,从而减轻瘢痕和秃发、维持长期提升效果的方法.方法:同时应用颧脂肪垫悬吊法、眼轮匝肌瓣悬吊法和颞部三点减张悬吊法三种悬吊方式,使伤口主要锚着点的闭合张力降低.结果:2006年至2011年,在68例面部除皱术中运用该方法,无明显伤口瘢痕增生和秃发,面部提升效果维持时间长,无面神经损伤并发症出现.结论:悬吊预控张力方法使张力重新分布到深层结构,明显减轻了伤口瘢痕增生和秃发,操作简单、安全、效果持久.     

改良真皮内褥式减张缝合技术预防面部除皱术后脱发的效果

目的:探讨能降低面部除皱手术伤口张力并辅助悬吊上提重定位后的皮肤达到减轻瘢痕、预防秃发、维持长期提升效果的方法。方法:2016年6月至2018年10月,中国医学科学院整形外科医院整形外科就诊的33例要求面部除皱术女性患者,年龄36～61岁,平均46岁。在额部或颞部开放切口除皱术后,在切口前方发际线与皮肤交界处,用2-0...     

Minimal incision face-lifting

Rhytidectomy has been performed for over 100 years, but only more recently has it become generally accepted by society. Recent improvements in access to information has produced more public awareness of the possible aesthetic enhancements. Additionally, there has been a trend for the younger patient to seek cosmetic surgery, often requesting procedures with minimal incisions and less downtime. The mini-lift, with its decreased operating time and expense, rapid recovery, as well as more limited incisions and tissue elevation, is an ideal procedure for patients with a smaller degree of cheek and neck laxity. We describe our concept of the mini-lift and address what results can be expected.     

Some tips on face-lifting

The face-lift operation is not difficult for the well-trained otolaryngologist. However, as in every surgical procedure, there are certain techniques that facilite its performance and improve results. This paper discusses some of these techniques that have been developed during the past 20 years.     

Less invasive face-lifting: platysma anchoring techniques

An analysis of anatomic changes during aging of the face and neck has led to fundamental changes in surgical technique. As a result, the cutaneoplatysmal complex and submuscular aponeurotic system are now anchored to fixed and solid structures: the malar periosteum, parotid fascia, and prelobar fibrous tissue. This technique, which is called skin and platysma muscle anchoring, limits cervical cutaneous undermining and avoids a submental approach. A repositioning of the anatomic elements in their initial sites explains the natural aspect of the results.     

The management of mid-face fractures with intracranial injury

Recent advances have radically changed the management of facial fractures. CT scanning, extensive exposure, and rigid plate fixation in the setting of the trauma center have permitted early operation with improved results. A subset of patients with facial fractures will also have intracranial injuries (ICI). We sought to identify parameters associated with an increased risk for ICI. We also sought to examine the safety and limits of early craniofacial repair in patients with intracranial injuries. Of 114 mid-face fractures treated over a 1-year period, 43 (38%) had a concomitant ICI. The majority, 36 (84%), were from motor vehicle accidents (MVA). Frontal sinus and orbitoethmoid fractures were at the highest risk for ICI, although orbitozygomatic fractures caused by MVAs also had a surprisingly high incidence of ICI. Our results show that early craniofacial repair can be performed safely with appropriate general surgical and neurosurgical support.