双瓣法在睑袋成形术中的应用

目的探讨采用皮瓣和肌瓣法（简称双瓣法）行睑袋成形术的操作方法和临床效果。方法对36例采用下睑成形术切口人路，分别形成皮瓣和肌瓣，在皮肤和眼轮匝肌表面与眶隔之间进行分离，直达眶下缘凹陷部，术中充分剥离松解弓状缘眼轮匝肌，特别是泪槽处眶下缘骨膜面的眼轮匝肌，将眶隔脂肪释放，缝合固定于眶下缘下方骨膜面上，行睑颊沟填充。然后设计眼轮匝肌瓣，将眼轮匝肌瓣上提和缝合固定，提升面中部使下睑区域达到年轻化效果。结果36例术后未出现血肿和下睑退缩现象。所有患者术后经3～18个月随访，均未出现睑外翻及面神经损伤等并发症。结论双瓣法既能矫正睑袋畸形，又能有效提升面颊部，达到面中部年轻化的效果，是一种较好的睑袋切除术式。

Application of double-flap in eyelid blepharoplasty

Objective To explore the methodology of skin flap muscle flap （double flaps） and and effect of the double flaps on eyelid bag blepharoplasty. Methods Through lower eyelid incision, skin flap and muscle flap were formed, orbicularis muscle and orbital septum separated between the skin and flaps, direct access to the inferior orbital rim depression. Arcuate edge of the orbicularis mus- cle was fully stripped and released, especially the orbicularis muscle at the inferior orbital rim perioste- al surface. The orbital fat was released, sutured below the inferior orbital rim periosteal surface. The orbicularis muscle flap was designed, lift and fixed to enhance midface to achieve the rejuvenation effect in the lower eyelid region. Results The 36 patients treated had no hematoma and flinch in the lower eyelid. Within 3 to 18 months follow-up, there were no eetropion, and facial nerve damage and other complications. Conclusions Double-flap is a feasible method as it can effectively enhance midface rejuvenation and correct eyelid bags deformity.