颧脂肪垫悬吊联合皮瓣递进减张法行面中下部除皱术

目的：探索一种有效而安全的面中下部除皱方法。方法：采用发际缘-耳前-耳垂下-耳后切口,在SMAS筋膜浅层广泛分离面部皮瓣。范围：由切口向前至外眦、颧骨、近鼻唇沟,向下至下颌缘下2横指,显露颧脂肪垫,用缝线将颧脂肪垫向后上方、后方悬吊拉紧,将皮瓣通过递进减张法向切口方向舒平拉紧,剪除多余皮肤,缝合伤口,面部适当加压包扎。结果：随访6个月～2年,16例术后面中下部再年轻化效果明显,未发生皮肤坏死、面神经损伤、皮下血肿等并发症,切口瘢痕隐蔽。结论：该方法对面中下部除皱效果显著、确切,而且具有简便、安全等优点。     

颧脂肪垫悬吊技术辅以SMAS折叠的中面部除皱术

目的：出于中面部提升简单化的趋势,介绍一种颧脂肪垫提升和SMAS移位的除皱技术。以期改善颧下区域空虚、鼻唇沟加深等中面部老化的问题。方法：采用一种中面部年轻化方法,行颊部耳前SMAS折叠,同时将下垂的颧脂垫缝线悬吊于耳前筋膜,使老化中面部维持长期的提升效果。结果：2006～2010年,在52例面部除皱术中运用该技术,中面部提升效果维持时间长,恢复期短,无面神经损伤等严重并发症出现。结论：皮下层的安全剥离避免了面神经分支的损伤。颧脂肪垫悬吊技术辅以SMAS折叠术,避免了较长的恢复期和深层剥离可能导致的损伤。这种方法可作为独立的中面部手术在局麻下实施,操作简单、安全、效果持久。     

颧颊脂肪垫悬吊在面部除皱术中的应用

目的:通过在面部除皱术中做颧颊脂肪垫提升悬吊,探索一种简便的面部提升除皱的方法.方法:在面部除皱术中,把颧颊脂肪垫向上提升悬吊在颞部颞深筋膜上,自2007年以来,已为26例患者做了这种手术.结果:26例中,24例对术后面部的改善感到满意,2例不满意,所有患者均未出现并发症. 结论:在面部除皱术中,颧颊脂肪垫提升悬吊能有效地改善中面部组织松垂和老化,该法具有手术简便和术后恢复快的优点.     

耳前小切口颧脂肪垫悬吊术在中面部提升中的应用

目的：探讨通过耳前小切口行颧脂肪垫悬吊术的安全性和促进中面部提升的美容效果。方法：本组就医者12例,面部皮肤弹性良好,均表现为眼角下垂、颊部组织下降、鼻唇沟过深。在内镜辅助下,应用PTFE线,经耳前小切口行颧脂肪垫悬吊术,提升中面部,改善鼻唇沟加深、颊部组织下降等衰老面容。结果：随访观察6～12个月,12例均获得较好的中面部提升效果。除1例发生皮下积血外,无严重并发症,就医者满意。结论：对于面部皮肤组织弹性良好者,耳前小切口颧脂肪垫悬吊术是一种安全、有效、切口隐蔽的中面部年轻化技巧。     

改良面部小切口脂肪垫悬吊除皱术

目的 探讨在面中部佛手式连续悬吊除皱术的基础上,以最小的损伤为目的,将手术切口及剥离范围进一步缩小的方法 及效果.方法 自2011年2月至2012年2月,对接受改良面部小切口脂肪垫悬吊除皱术的患者共21例,采用颞部小切口、联合口腔前庭切口,用导针带PTFE悬吊线悬吊颞、颊部脂肪垫,用于治疗患者面中部皮肤松弛造成的鼻唇沟加深等情况.对随访患者记录术后肿胀时间、青紫消退时间、鼻唇沟改善情况,评价其效果.结果 本组共21例患者,视觉肿胀在术后8d全部消退,淤青于术后10d全部消退,平均消退(8.00±0.95)d;获随访3～12个月,面中部皮肤松弛得到改善,鼻唇沟改善效果满意.结论 改良面部小切口脂肪垫悬吊除皱术对于改善面中部松弛造成的鼻唇沟加深,效果良好,术后恢复时间短,疗效稳定.     

内镜辅助下颧、颊脂肪垫悬吊除皱术的临床应用

自从Owsley、Yousif提出颧脂肪垫（malarfatpad）的概念以来，中面部提升术取得了很大的进展。但是传统的颧、颊脂肪垫提升术需要颞部设计切口延续到耳前和耳屏前，耳前瘢痕明显，是很多医者和受术者双方的顾忌。我们对16例中上面部除皱者在内镜辅助下，应用微小切口，使耳部切口仅延续约1cm（耳屏上），即可完成颧脂肪垫（包括颧部脂肪垫和颊部脂肪垫）的悬吊，提升中面部，改善鼻唇沟加深、颊部组织下垂、眶下区变深等衰老、憔悴面容等表现。最近两年来，我们共已完成了16例，现报告如下。     

改良的中下面部三维综合除皱术在面部年轻化中的应用

目的：探索应用改进的综合方法对中下面部进行三维除皱术,以恢复年轻时的面部立体轮廓形态。方法：局部麻醉下进行中下面部三维除皱术,术中应用了改进的筋膜悬吊、面颊部软组织折叠,下颌部超声去脂、面部局部吸脂、脂肪充填等手术方法;其中将传统的筋膜悬吊改进为多层次的分段提紧和选择性的连续提紧方法。结果：2006年1月～2009年10月间,采用此法完成手术56例,不仅提高了除皱效果,还减少了愈合后瘢痕的形成。结论：通过以上手术方法不仅术后除皱效果良好,而且使面部轮廓形态得到了显著改善,三维面部年轻化的概念也得到了体现。     

眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊的中面部年轻化效果分析

目的探讨眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊的中面部年轻化效果。方法以72例进行面中部整形者为观察对象,应用眉部和下睑缘切口对颧脂肪垫及眼轮匝肌悬吊法进行手术。分析术后1周、3个月、6个月和1 a的治疗效果,观察有无外眦变形、下睑外翻或退缩、瘢痕增生等并发症。结果患者均未出现外眦变形、下睑外翻和面神经损伤并发症。4例患者下睑外眦切口末端有少许猫耳,3~6个月后自行消失。2例术后1周时出现双侧鼻唇沟不对称,采用脂肪填充后被矫正。3例患者术后外眦水肿较明显,经射频治疗后逐渐恢复。3例患者早期诉眼部干涩,3个月后症状消失。其余患者效果满意,中面部老化状态得到良好矫正,且无其他并发症和继发畸形出现。结论眉部和下睑缘切口对颧脂肪垫和眼轮匝肌悬吊处理效果满意,手术切口小且无面神经损伤,有效提高中面部的年轻化美容效果。     

小切口面部除皱术联合自体脂肪面部填充在面部年轻化手术中的应用效果

目的 探究小切口面部除皱术联合自体脂肪面部填充在面部年轻化手术中的应用效果。方法 选取 2021年1-12月我院收治的78例面部年轻化手术患者作为研究对象,随机分为对照组与观察组,每组39例。 对照组使用小切口面部除皱术治疗,观察组使用小切口面部除皱术+自体脂肪面部填充方式治疗,比较两 组面部定量指标、并发症发生率、临床疗效以及满意度情况。结果 两组治疗后瞳孔点至鼻唇沟与瞳孔垂 线交点距离短于治疗前,且观察组短于对照组,ABC弧度小于治疗前,且观察组小于对照组,差异有统计 学意义（P＜0.05）;两组治疗后双侧颧点间距比较,差异无统计学意义（P＞0.05）;观察组并发症总发 生率高于对照组,但差异无统计学意义（P＞0.05）;观察组1周及1年后优良率均高于对照组,差异有统计 学意义（P＜0.05）;观察组术后1周、1年满意度均高于对照组,差异有统计学意义（P＜0.05）。结论 使 用小切口面部除皱术联合自体脂肪面部填充方式进行面部年轻化手术,近远期效果理想,患者满意度较 高,且不会增加并发症发生几率,值得临床应用。     

小切口面部除皱术联合自体脂肪面部填充应用在面部年轻化手术中的效果

探讨面部年轻化治疗中应用自体脂肪面部填充联合小切口面部除皱术的效果。方法 选取2018年2月-2023年2月于本院行面部年轻化治疗的30例患者为研究对象,依据治疗方法不同分为单独组和联合组,各15例。单独组采用小切口面部除皱术治疗,联合组采用自体脂肪面部填充联合小切口面部除皱术治疗,比较两组面部定量指标、下颌缘、鼻唇沟形态评分、面部皮肤检测指标、临床疗效、美容满意度及并发症发生情况。结果 联合组治疗后双侧颧点间距、瞳孔垂线和鼻唇沟交点到瞳孔点距离、瞳孔垂线与口裂线和鼻底线在下颌轮廓交点弧度均小于单独组（P ＜0.05）;联合组治疗后下颌缘形态、鼻唇沟形态评分均低于单独组（P＜0.05）;联合组治疗后弹性、水分评分高于单独组,斑点、油脂评分低于单独组（P＜0.05）;联合组治疗优良率为93.33%,高于单独组的80.00%（P＜0.05）;联合组美容满意度评分均高于单独组（P ＜0.05）;两组并发症发生率比较,差异无统计学意义（P ＞0.05）。结论 小切口面部除皱术联合自体脂肪面部填充的面部年轻化治疗效果优于单独小切口面部除皱术,可改善面部定量指标和面部皮肤检测指标,优化下颌缘、鼻唇沟形态,且不会增加不良反应发生风险,患者满意度较高。     

Male face lift

The author describes how to use the deep layer support technique for male face lift to achieve natural-looking results and virtually undetectable scars. He discusses incisions and neck contouring in detail and provides pointers on eliminating crow's-feet. (Aesthetic Surg J 2002;22:385-396.)     

Clinical analysis of malar fat pad re-elevation

Primary suture suspension of the malar fat pad has been described as a safe and simple component of global facial rejuvenation. This review evaluates the efficacy and indications for re-elevation of the malar fat pad elevation. A retrospective review of the medical records of patients who underwent malar fat pad elevation was performed between 1994 and 2000. Of 472 procedures, 14 involved re-elevation of the malar fat pad. These cases were examined for complications, risks, and results. Secondary midface elevation was performed using a subcutaneous approach to the malar fat pad through a pre-hairline incision and vertical suspension of the malar fat pad to the temporoparietal fascia. The indications for re-elevation of the malar fat pad included nasolabial asymmetry, malar fat pad malposition, and malar fat pad asymmetry. Primary elevation of the malar fat was performed in 472 patients. Fourteen of these patients had suboptimal results that necessitated re-elevation of their malar fat pads. Their average age was 57.5 years. Of the 14 malar fat pad elevations, 12 included SMAS procedures, nine were combined with platysmal plication/submental lipectomy, six with forehead lift, and three with eyelid procedures. The average interval between original malar fat pad elevation and the re-elevation was 40 months. Average follow-up was 15 months. Complications were seen in five patients, with the most significant being persistent eye irritation. Two patients had some minimal scar hypertrophy, which was self-limiting. Minor preauricular skin slough developed in one patient. Restoration of the youthful position of the deep structures in patients with a previous mid-facelift was successfully achieved by re-elevating the malar fat pad in a vertical direction. Re-elevation of the malar fat pad demonstrated effective and reliable long-term results. It is appropriate in the small number of patients who require revision or improvement of midface rejuvenation using the malar fat pad suspension technique.     

Suture suspension of the malar fat pad

Background: Elevation of the malar fat pad by use of suture suspension to rejuvenate the central third of the face has been previously described. Objective: The authors evaluated the ability of suture suspension to successfully elevate the malar fat pad. Methods: Four fresh frozen cadaver dissections were studied. With the standard preauricular, subcutaneous approach, the malar fat pad was identified, and a suspension suture was placed at the inferior and lateral aspect of the fat pad. The vector of pull was directed vertically, and the tension that was applied to the suture was measured. The dermis was then elevated from the malar fat pad to examine suture placement and ensure that the dermis was not caught in the suture. Results: An average tension of 11 lb was applied before rupture of the suture. In none of the cases did the suture pull through the malar fat pad. Conclusions: Suture suspension is an effective technique for elevation of the malar fat pad. The results are easy to reproduce and are very effective in addressing the changes that accompany aging and the descent of the malar fat pad. (Aesthetic Surg J 2002;22:446-450.)     

Limited-incision face lift technique

Background: For the past 4 decades, the full subcutaneous face lift has been the procedure of choice for treatment of the facial effects of aging. Objective: We report the use of a less invasive procedure, the limited-incision face lift technique (LIFT), in a series of 1000 patients from January 1991 through January 2001. Methods: Each of the lift procedures was performed while the patient was under intravenous sedation and local field block infiltration; no narcotics were administered. Suction-assisted lipoplasty was used to defat the submental area and jowls, except in cases of prominent platysmal bands in the erect position, when open lipoplasty was performed. Undermining was carried medially 5 to 6 cm from the preauricular incision throughout the cheek and over the mandible to the submental area. The superficial musculoaponeurotic system (SMAS) was then developed distally; redundant SMAS tissue was resected at the apex of the closure and along its posterior border, followed by plication and closure. Results: Patients were pleased with the operative experience and surgical results. Complications included 6 cases of hematoma that required surgical drainage. There were also numerous small collections. In addition, development of skin ripples behind the ear lobule occurred in some patients early in the series but virtually disappeared as we gained experience in the procedure. The necessity for immediate neck lifts as an additional procedure occurred in 6 early patients but was eliminated by careful patient evaluation for neck skin laxity later in the series. Conclusions: The LIFT is an alternative to the traditional face lift. Advantages include limited incision and scar as well as excellent correction of nasolabial folds, cheek laxity, jowls, and redundant submental skin and fat. It is not indicated for patients with significant lower neck skin laxity. (Aesthetic Surg J 2001;21:216-226.)