全口内微切口颧骨复合体缩小整形术

目的：寻找一种体表没有手术痕迹，可以自如地调整颧骨复合体任何部位的宽窄程度，使面部有效达到三维立体缩小的颧骨整形手术方法。方法：采用全口内切口，自颧弓后间隙入路，不剥离功能性肌肉。用往复锯行颧骨体和颧弓根部截骨，根据患者的具体情况和要求，自如调整颧骨复合体移位的位置和幅度，将肥大的颧骨和颧弓按照自然弧度自如地推入到理想的位置。用锦纶编织线将断端捆绑式固定，切口采用可吸收缝线分层缝合。结果：本组全口内切口入路颧骨复合体缩小术296例效果满意。结论：①全口内切口入路，体表不会遗留任何手术痕迹；②颧弓后间隙行颧弓根部和颧骨体截骨，非常安全；根据患者的具体情况和要求，自如地调整颧骨复合体宽度和突度，从而达到颧骨复合体最大幅度、最有效地立体缩小；③颧骨截骨断端采用锦纶编织线捆绑式固定，不仅固定牢固，而且术后在x线下不会显影：④术野功能性肌肉不做剥离，切口分层缝合，术后不会出现软组织下垂。

Intraoral approach zygomatic complex reduction plastic surgery

Objective To explore an effective method of getting face tridimensional reduced without any trace and adjusting any parts＂ width range of zygomatic complex. Methods Malar osteotomies have been performed to move the zygomatic complex to the realistic position according to patients request through an intraoral incision for reducing malar and zygomatic bone with oscillating saw, and fixed by nylon suture. The incision sutured by absorbable suture. Results Postoperative follow up showed satisfactory results in all 296 cases. Conclusion （1）here is no scars remain in body surface after surgery. （2）It is safe to have malar and zygoma osteotomies through zygoma arch space. According to patient＇s requirement adjusting zygoma width range and process to get the most effective results of zygomatic complex reduction in tridimensional. （3）Zygomatic osteotomy ends fixed by nylon suture and after the X-ray imaging would not appear. （4）The functional muscle won＇t be dissection and incision is sutured stratified to prevent the facial slack.