内镜额部除皱术结合传统切开法除皱的效果

目的探讨内镜除皱术与传统除皱术相结合的治疗方式及效果。方法仅存在额部皱纹、眉间纹及眉下垂者采用内镜额部除皱术，切除或切断皱眉肌、降眉肌和额肌，必要时结合额部皮瓣上提悬吊技术即可；如同时存在中下面部皮肤老化、松弛下垂，则内镜额部除皱术尚需结合传统切开法的中面部或中下面部除皱术，做浅表肌腱膜系统（sMAs）筋膜的折叠或切除缝合，以及多余皮肤的切除剪裁。结果104例采用额部内镜除皱术，均取得良好的除皱和眉提升效果。并发症较少而轻微，包括表情肌去除部位的轻度凹陷、额部皮肤麻木、发际线轻微后移、皱纹去除不彻底等。无面神经颞支损伤等严重并发症发生。其中84例存在中下面部皮肤松弛下垂，在做内镜额部除皱的同时行耳前切口的传统除皱术，明显改善中下面部的皮肤老化，并使面部上下的年轻化协调一致。结论内镜额部除皱术设计合理、操作安全、效果明确，是一项切口小、损伤轻的微创技术，符合整形外科的发展趋势。对于同时存在有中下面部皮肤松弛者，如能结合传统切开法除皱术，面部年轻化的整体效果可进一步优化。

Endoscopic forehead lift in combination with conventional facelift

Objective To investigate the techniques and signifcations of endoscopic forehead lift when it was done alone or in combination with conventional facelifting. Methods For the patients with forehead transverse wrinkle, vertical frown line and eyebrow ptosis, resection of partial frontalis muscle, procerus muscle and corrugator muscle was performed. If the patients had obvious excessive and drooping skin in middle face and lower face together with the wrinkles that were mentioned above, endoscopic forehead lift in combination with conventional facelifting was done at the mean time. The excessive skin was tailored and removed, SMAS was complicated or resected and sutured. Results 104 patients were subjected to the endoscopic forehead lift, in which 20 cases underwent it alone, and another 84 cases were treated in combination with the conventional facelifting. Of all cases, 104 pa tients presented satisfactory results of forehead. They showed the eliminating of transverse wrinkle of forehead, glabellas vertical fold and lifting of eyebrow ptosis. Complications were less and minimal, including minimal local depression, retrodisplacement of hairline of forehead, recurrence of wrinkle and numb of forehead. No injuring of temporal branch of facial nerve occurred in this group. The cases that underwent endoscopic forehead lift in combination with conventional faeelift showed the coordinate and consistence of rejuvenation from forehead to middle face and lower face. Conclusions Endoscopic forehead lift is a minimally invasive technique, and it presents more satisfactory results with less se vere complications, lts operative principle is reasonable, procedure is safe and reliable, and therefore it represents the tendency of developing of plastic surgery and cosmetic surgery. If patients have obvious excessive and drooping skin in middle face and lower face, endoscopic forehead lift is suggested in com bination with the conventional facelift, and this resolution shows more balanced and coordinate cos metic correction of whole face.