多层综合除皱术

目的应用多层综合的除皱方法使老化的面部年轻化。方法进行多层次解剖分离，使老化移位的组织复位。包括皮肤及骨膜层的提紧，ＳＭＡＳ的悬吊，颧弓韧带的重建，颧骨的修薄。结果自１９９３年以来，完成手术２８例，效果满意。结论面部老化是不同组织，不同解剖结构变化的综合体现。单一层次的除皱方法不能取得全面的年轻化效果，多层综合的除皱方法恢复了年轻的解剖生理关系，使因老化导致的面部软组织的松弛移位得到充分的矫正，具有全面的年轻化效果     

多层综合除皱术

应用多层综合的除皱方法使老化的面部年轻化。方法 进行多层次解剖分离，使老化移位的组织复位。包括皮肤及骨膜层的提紧，ＳＭＡＳ的悬吊，颧弓韧带的重建，颧骨的修薄。结果 自１９９３年以来，完成手术２８例，效果满意。结论面部老化是不同组织，不同解剖结构变化的综合体现。     

个性化处理SMAS层的面部年轻化手术

目的:总结并探讨各种通过SMAS个性化处理达到面部年轻化的除皱手术方法.方法:回顾研究56例面部老化患者的治疗过程,根据患者自身老化程度,行相应区域的SMAS广泛剥离,并以不同方式个性化处理SMAS层,达到对面部软组织年轻化重塑的手术方法和术后效果.结果:术后随访6月～2年,面部软组织均获得显著的年轻化效果,术后56例患者均较满意.结论:根据患者自身的老化程度,以不同方式个性化处理 SMAS层的面部年轻化手术,是安全有效的软组织提升方法,可达到除皱术更为持久的年轻化效果.     

全面部多层次复合除皱术

目的：探讨应用多层次复合除皱法使面部年轻化手术的效果及价值。方法：进行多层次解剖分离,使松弛移位的组织复位,包括额部、颧弓部位的骨膜下分离,眼轮匝肌紧缩,额肌部分切除、SMAS-颈阔肌瓣的悬吊提紧等。结果：本组17例患者,均获得良好的手术效果,皮肤松垂得以复位,面部轮廓清晰,形态完美,效果满意。结论：多层次复合除皱技术,效果确切、可靠、安全、持久,是面部皮肤老化松弛的理想治疗方法。     

改良骨膜下综合剥离除皱术100例分析

目的　为了更有效地使面中部老化组织向上提紧复位。　方法　采用扩大的面部骨膜下剥离 ,或加用 SMAS下和皮下多层次综合剥离除皱术。尤其在颧弓部骨膜下进行剥离松解 ,掀起颧弓韧带的起点 ,以解除面中部老化组织上提复位的屏障。　结果　本组 10 0例术后显示恢复了面部各层组织年轻时的解剖关系 ,获得了年轻时鼻唇沟的形态和颌线轮廓 ,效果满意。未出现面神经额支受牵拉损伤的征象。　结论　本法适用于不同年龄 ,尤其是 40岁左右的除皱者     

改良骨膜下综合剥防除皱术100例分析

目的 为了更有效地使面中部老化组织向上提紧复位。方法 采用扩大的面部骨膜下剥离，或加用ＳＭＡＳ下和皮下多层次综合剥离除皱术。尤其在颧弓部骨膜下进行剥离松解，掀起颧弓韧带的起点，以解除面中部老化组织上提复位的屏障。结果 本组１００例术后显示恢复面部各层组织年轻时的解剖关系，获得了年轻时鼻唇沟的形态和颌线轮廓，效果满意。未出现面神经额支受牵拉损伤的征象。结论 本法适用于不同年龄，尤其是４０岁左右的除皱     

中面部脂肪室研究进展及相关临床应用北大核心CSCD

目的综述中面部脂肪室相关研究进展,全面了解中面部脂肪室解剖及其老化的形态表现、相关临床应用现状。方法广泛查阅近年来中面部脂肪室研究及临床应用的相关文献,并进行综合分析。结果中面部脂肪层曾被认为是融合而连续的层次,在老化的过程中表现为脂肪整体萎缩。随着解剖研究的深入,新近研究表明中面部脂肪层被筋膜、韧带或肌肉分隔为多个脂肪室,并分成深、浅两层,在老化过程中表现为浅层肥大而深层萎缩。临床应用表明,对深内侧面颊脂肪室及Ristow’s space进行脂肪容量填充,可有效恢复中面部年轻化外观。结论中面部脂肪室的研究取得了显著进展,为脂肪容量填充的临床应用提供了新的理论依据。根据不同部位、不同层面的脂肪室发生的不同老化改变进行相应处理,可实现中面部年轻化。     

中面部脂肪室研究进展及相关临床应用

目的综述中面部脂肪室相关研究进展,全面了解中面部脂肪室解剖及其老化的形态表现、相关临床应用现状。方法广泛查阅近年来中面部脂肪室研究及临床应用的相关文献,并进行综合分析。结果中面部脂肪层曾被认为是融合而连续的层次,在老化的过程中表现为脂肪整体萎缩。随着解剖研究的深入,新近研究表明中面部脂肪层被筋膜、韧带或肌肉分隔为多个脂肪室,并分成深、浅两层,在老化过程中表现为浅层肥大而深层萎缩。临床应用表明,对深内侧面颊脂肪室及Ristow’s space进行脂肪容量填充,可有效恢复中面部年轻化外观。结论中面部脂肪室的研究取得了显著进展,为脂肪容量填充的临床应用提供了新的理论依据。根据不同部位、不同层面的脂肪室发生的不同老化改变进行相应处理,可实现中面部年轻化。     

眉间部表情肌及相关组织的解剖学研究及治疗进展

正随着年轻化美容需求的增加,针对面部衰老的解决方法有许多种,如传统的除皱手术、配合内窥镜的除皱手术、肉毒毒素注射以及射频消融等。而眉间部区域解剖结构庞杂,老化的机制也繁复~([1-2])。因此,眉间部除皱术一直是面部年轻化治疗中的重点和难点。为了更好地解决这一难题,着重于这     

Nlite激光联合微电针除皱在面部年轻化中的应用

目的：探讨将Nlite激光联合微电针除皱应用于面部年轻化美容的临床效果。方法：对皮肤松弛或皱纹明显的面部老化者,联合应用Nlite激光和微电针进行除皱治疗。结果：63例面部皮肤老化者,总有效率为98%,半年有效维持率78%,疗效满意。结论：Nlite激光联合微电针除皱既能改善面部浅表皱纹又能收缩面部肌肉促进其紧缩,具有起效快、效果显著及疗效持久的特点,是面部年轻化美容的好方法。     

Surgical anatomy of the midface as applied to facial rejuvenation

Distinct anatomic structures provide attachments and support for the soft tissues of the central third of the face. Over time, laxity of these structures and descent of the malar fat pad contribute to the characteristic changes seen in the aging face. Mobilization of the midface soft tissues to allow reelevation of the malar fat pad is an effective method of rejuvenating the midface. A focused anatomic dissection of 8 fresh cadaver heads was performed to evaluate 4 soft-tissue structures that control mobilization of the malar fat pad. Specifically, the orbicularis retaining ligaments, the lateral orbital thickening, prezygomatic space, and zygomatic cutaneous ligaments were evaluated. The anatomic relationship of these structures explains the visible effect of aging in the central third of the face. In addition, it correlates with the outcomes of surgical rejuvenation as demonstrated in clinical cases. Effective repositioning of the malar fat pad was found to be reliably obtained by release of the lateral orbital thickening and the orbital retaining ligaments. Suspension of the malar soft tissue is in a cephalad direction after release of these structures recreates a youthful facial architecture. Motor nerve injury is less likely to occur with this technique than with traditional lateral facelift approaches. The conclusion reached is that ptosis of the malar fat pad can be corrected safely and effectively utilizing either the lower lid blepharoplasty approach or temporal prehairline incision. These findings were consistent with clinical data from facial rejuvenation procedures.     

Rejuvenation of the aging neck

Patients seeking rejuvenation of the face are influenced by youthful faces commonly seen in the media and entertainment world. Although standards of beauty evolve over time, classical facial features such as symmetry, high cheek bones, and an angular jaw-neck line remain as ideals. As the human face ages, a relatively consistent series of anatomic events occurs. Although the rate of change varies from person to person, the process of facial aging is predictable. This process involves a loss of tone of the elastic fibers of the face, resulting in sagging of the skin and soft tissues of the face and neck. Additionally, aging of the lower face often includes ptosis of the soft tissues of the chin and banding or cording of the muscles of the anterior neck. Aesthetic rejuvenation of the face and neck involves repositioning of poorly supported soft tissues. To accurately treat facial aging, an individualized diagnosis and anatomically based problem list is compiled. This should include analysis of the skin quality, bone structure, amount and distribution of subcutaneous fat, and relationship of the superficial muscles to the overlying skin. After a detailed diagnosis is made, a surgical treatment plan is outlined to improve the face and restore a youthful appearance. This article describes the applied anatomy associated with facial aging and explains the author's specific techniques to obtain a natural postoperative appearance. Avoidance of common problems associated with aging face surgery is emphasized.     

Superficial fascia rhytidectomy. A restoration of the SMAS with control of the cervicomental angle

The surgical correction of an anatomic defect should re-establish the normal relationship of the tissues which contribute to the defect and restore or improve function. When the repair of the anatomic defect is not maintained, it may be necessary to alter the tissues to accomplish a more lasting result. Restoration of the SMAS cephalad to the cervicomental angle by superficial fascia rhytidectomy with a complete transverse resection of a segment of the platysma muscle at the level of the cervicomental angle fulfills the criteria of the young face by improving the function and contours of the face (changes that are characteristic of aging).     

Technique of Periorbital Lipoaugmentation

With aging comes atrophy of the periorbital subcutaneous fat. This leads to abnormal relationships between the orbital and neighboring cosmetic units, with a loss of the anterior projection of the upper third of the face, relative skin excess, and inferior displacement of tissues. Multistage, blunt infiltration with autologous fat is an excellent way to correct these incipient senescent changes.     

Panfacial Volume Restoration with Fat

Background. A careful look at the aging face shows it to consist of more than loose skin and rhytids. With aging, the face loses its anterior projection, with a resultant displacement of skin inferiorly. There is mimetic muscular accentuation and an abundance of deep grooves and shadows. In addition, fat redistributes in specific patterns in overweight versus lean individuals.
Objective. To restore the three-dimensional projection and overall shape of the face to more youthful contours and to eliminate shadowing and muscle to skin interactions.
Methods. Autologous fat is harvested with an open-tipped, blunt cannula under tumescent anesthesia. It is then transferred to 1 mL syringes for injection into the face under local anesthesia. Fat is woven into the deep tissues of the face using a small-bore blunt cannula. The entire face is addressed by filling one cosmetic unit at a time. Fat is anchored deep to the muscles, in the muscles, and subcutaneously depending on the anatomic site and desired result.
Results. Dramatic changes in contour are achieved with judicious placement of fat. Skin redraping and the interruption of muscle to skin interactions occur when autologous fat is infiltrated in small aliquots, with specific direction at appropriate tissue levels. Complications are rare and minor with this technique.
Conclusions. Autologous fat is an excellent tool for replacing volume and restoring contour to the aging face.