下睑缘和口内联合切口面中部提升术

目的:探讨经下睑缘和口内联合切口骨膜下面中部提升手术方法的临床疗效和解剖基础。方法:采用下睑袋切除术的手术切口,在眼轮匝肌下层次常规完成下睑松弛皮肤切除术后,于眶缘下2￣3mm切开骨膜,通过口内切口在梨状孔下缘水平切开骨膜,共同完成颧骨和上颌骨的骨膜下分离,外侧的分离止于颧大肌起点的内侧,内侧为鼻骨与上颌骨转折处。切开剥离范围内、外侧骨膜,将颊部脂肪垫的前叶及其下的骨膜,颧部的皮下脂肪垫向上外固定,然后将骨膜与眶缘的骨膜向上外方重叠缝合,缝合下睑切口。结果:采用本方法临床治疗下睑皮肤松弛和面中部老化患者13例,并发症轻,可同时达到下睑和面中部满意的美容效果。结论:本方法切口隐蔽,并发症少,可作为面中部年轻化手术的推荐使用方法。

Oral and subciliary incision subperiosteal cheek lift

Objective To explore the clinical results and anatomic basement of oral and subciliary incision subperiosteal cheek lift. Methods A subciliary incision were performed and a lower eyelid skin muscle flap, preserving a 4-mm strip of orbicularis oculi muscle, was dissected inferiorly to the infraorbital rim. After completion of the skin and fat excision, the dissection was continued 2mm to 3 mm inferior to the infraorbital rim, and a periosteal incision was made parallel to the rim and then crossed the lateral rim 2 to 3 mm inferior to the lateral canthus. The dissection was continued over the malar eminence and proceeded medially to the nasomaxillary junction and laterally stopping just medial to the zygomaticus major muscle. Through a oral incision the subperissteal dissection was made upward with the connection of the subciliary incision. Once the dissection was complete, the medial and lateral periosteum was incised around the extent of the dissection. The first suspension suture lifts the anterior lobe of buccal fat pad in superior and laterial direction, and then periosteum was duplicated to the superior periosteum in the same direction. Finally the malar fat pad was suspended. The subciliary incision was then closed in the usual manner. Results 13 patients with aging midface and lower eyelid gained satisfactory results after this approach. Conclusion It is an ideal methods for the rejuvenation of the aging midface and lower eyelids with a concealing incision and small complications.