面部小切口悬吊除皱术

目的 在小切口除皱基础上增加悬吊技术，探讨悬吊术的手术要点及并发症的发生原因和处理方法，以其达到最佳的除皱效果。方法 行额部、头顶部帽状腱膜下及颞部、颊部皮下小切口分离术区，切断且松解部分额肌、皱眉肌，利用Gore-Tex线拉紧松驰的头皮达到悬吊除皱目的。结果 笔者为96例患者行上半面部小切口悬吊除皱术，门诊随访35例，大多数患者取得满意的除皱效果，无严重并发症性。结论 面部小切口悬吊除皱术在小切口分离的基础上增加了悬吊的力量，比传统手术方法操作相对简单、组织损伤轻、并发症少、除皱效果确切、值得推广。     

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.     

改良颧脂肪垫悬吊中下面部除皱术

目的 改进中面部除皱的手术方法,对手术要点进行探讨.方法 对于颈部松垂不明显、颌下脂肪堆积不严重者,切口限制在颞部和耳前部,不延伸到耳后;皮下分离后,将颧脂肪垫用不可吸收线缝合悬吊于颞深筋膜,颊部SMAS向后上方向提升,折叠缝合,皮肤向上提升.结果 自2002年10月至2009年12月,应用该方法进行中面部除皱137例,随访1～3年,手术效果满意.1例患者术后右侧面神经颊支损伤,1个月后自然恢复,1例右侧耳前皮下局部感染,清创后愈合.无皮下血肿及皮肤坏死发生.结论 提升下垂的颧脂肪垫,重建中面部年轻凸出的曲线是中面部除皱的关键,术中将皮瓣向上提升可以有效减少手术瘢痕.     

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。     

面部小切口悬吊除皱术

目的在小切口除皱基础上增加悬吊技术,探讨悬吊术的手术要点及并发症的发生原因和处理方法,以其达到最佳的除皱效果.方法行额部、头顶部帽状腱膜下及颞部、颊部皮下小切口分离术区,切断且松解部分额肌、皱眉肌,利用Gore-Tex线拉紧松弛的皮肤达到悬吊除皱目的.结果笔者为96例患者行上半面部小切口悬吊除皱术,门诊随访35例,大多数患者取得满意的除皱效果,无严重并发症发生.结论面部小切口悬吊除皱术在小切口分离的基础上增加了悬吊的力量,比传统手术方法操作相对简单、组织损伤轻、并发症少、除皱效果确切、值得推广.     

面部小切口悬吊除皱术

目的　在小切口除皱基础上增加悬吊技术 ,探讨悬吊术的手术要点及并发症的发生原因和处理方法 ,以其达到最佳的除皱效果。方法　行额部、头顶部帽状腱膜下及颞部、颊部皮下小切口分离术区 ,切断且松解部分额肌、皱眉肌 ,利用Gore -Tex线拉紧松弛的皮肤达到悬吊除皱目的。结果　笔者为 96例患者行上半面部小切口悬吊除皱术 ,门诊随访 3 5例 ,大多数患者取得满意的除皱效果 ,无严重并发症发生。结论　面部小切口悬吊除皱术在小切口分离的基础上增加了悬吊的力量 ,比传统手术方法操作相对简单、组织损伤轻、并发症少、除皱效果确切、值得推广     

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。     

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。     

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。     

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.)     

Malar fat pad suspension through intraoral approach: a personal technique

Background

For decades, facelifting has been the gold standard for facial rejuvenation. However, there is a current tendency towards new and less complex procedures. The reposition of the malar fat pad plays a central role to restore a convex mid-face contour, and until now, it has been achieved mainly through large incisions or endoscopic techniques.

Methods

Authors present a minimum scar procedure using a 20-cm needle: a 45-min operation that lifts the ptotic malar fat to restore a youthful looking facialvolume. Nineteen consecutive patients were addressed using this technique with consistent satisfactory results between the years 2007 and 2012.

Results

Patients were mostly women (16), between 24 and 70 years of age. Six patients had this procedure as a single surgery, the rest in combination with other aesthetic procedures. All of them were satisfied with results at one year after the procedure operation.

Conclusions

The authors conclude that this is a reliable procedure that obtains the desired results in mid-face rejuvenation by restoring a youthful contour, avoiding large visible incisions.

Level of evidence: Level IV, therapeutic study

     

Experience with percutaneous suspension of the malar fat pad for midface rejuvenation

Repositioning of the ptotic malar fat pad represents a key element of midface rejuvenation. Traditional face-lifting techniques have been minimally effective in correcting the midface changes commonly seen in aging. Many candidates, especially younger patients, desire procedures that have rapid recovery times with reduced risk and the absence of visible incisions. Percutaneous suspension of the malar fat pad to reposition it in a more youthful position is a minimally invasive technique producing a long lasting elevation that would be a welcomed addition to midface rejuvenation.     

The hypothenar fat pad transposition flap: a modified surgical technique

The hypothenar fat pad flap has been shown to produce reliable clinical results for the treatment of recurrent carpal tunnel syndrome secondary to cicatricial tethering. The flap utilizes soft vascularized tissue that does not compromise hand function and is of sufficient size to provide median nerve coverage in the carpal tunnel. We describe technical modifications that facilitate improved, tension-free transposition of the pedicled fat pad flap. These modifications enable transfer of vascularized tissue and decrease iatrogenic damage to the important perforator vessels. The hypothenar fat pad transposition flap provides a reliable source of vascularized local tissue that can be used successfully as an adjunct to neurolysis for the treatment of recurrent idiopathic CTS secondary to perineural scarring.     

Labial fat pad grafts (modified Martius graft) in complex perianal fistulas

Complex perianal fistulas may at times be very difficult to treat. New vascularised tissue can reach the perineum from leg muscles and the omentum. A less well-known source is the labial fat tissue (modified Martius graft) which has a robust posterolateral pedicle and which can be useful as an adjunctive technique for high anterior anal and rectovaginal fistulas. Between November 1993 and July 1997, eight women (age range 18-55 years) underwent modified Martius grafting, six of the eight having a rectovaginal fistula and two a high complex (suprasphincteric) perianal fistula. Anorectal advancement flaps were performed in five patients and three had a transperineal approach with simultaneous anterior sphincter repair because of concurrent anal incontinence. All patients had a defunctioning stoma. The fistula healed in six of the eight patients (75%) and recurred in two patients. The stoma has been closed in five of the eight patients (one patient's fistula has healed but her stoma cannot be closed because of anal incontinence). This is a useful technique when confronted with a difficult anterior fistula in women.     

Glomus tumor of the fat pad

The authors report an exceptional glomus tumor location in Hoffa's ligament in a 65-year-old man. Based on this observation and a literature review, the authors provide the clinical and radiographic diagnostic appearances of this type of tumor. Surgical removal of the tumor achieved immediate disappearance of knee pain. Histological examination of the tumor has established the definitive diagnosis.Arthroscopy 1998 Apr;14(3):325-8