眶脂肪眶隔弓缘释放下睑袋整复术与传统术式的年轻化效果比较

发布时间：2018-10-16 19:32

【摘要】：目的:既往传统睑袋去除眶脂肪术较为简单,对下睑袋臃肿形态进行简单处理,而对面中部过渡区域的泪槽畸形等老化形态却没有改善。本文通过对眶脂肪眶隔弓缘释放下睑袋整复术和传统术式两种方法进行对比,来研究和探讨睑袋整复术中应用眶脂肪眶隔弓缘释放术修复下睑袋方法在临床应用上的优势及其对面中部年轻化的临床效果。方法:选用需要进行美容手术患者36例。将这些患者进行随机分组,分为两组,每组18例,一组用传统睑袋修复术即去除眶脂肪法,一组用眶脂肪眶隔弓缘释放法睑袋整复术,即在睑袋整形术基础上,将眶隔筋膜打开,原有的眶脂肪去除变为保留,眶脂释放并固定于眶下缘的骨膜或软组织上,以填充眶下缘凹陷区,使下睑较为丰满。两组根据患者皮肤松弛程度、年龄大小、接受度等情况采用经结膜入路或经皮肤入路。在睑袋下缘凹陷区任意定点,测量它与鼻尖所在且与面部平行的垂直平面的距离,术前与术后分别测量,比较和观察前后距离变化,并进行统计学分析。术后一年内进行随访。结果:本组共36例,于2009年6月至2010年6月期间,随访三个月至一年,术后1名患者略有肿胀,肿胀消退较慢。发现用传统睑袋修复方法的患者对手术较满意,下睑臃肿形态得到明显改善,但是泪槽凹陷等状况改善不明显;有些患者面中部骷髅状老化形态会逐渐显现。应用眶脂肪眶隔弓缘释放术的患者均对手术效果满意,下眼睑袋状外观均消失或改善,下睑眶缘沟、鼻颊沟、眶颊沟等凹陷畸形得到缓解和解决,明显得到矫正,恢复自然、圆润、丰满的下睑轮廓。外眼角、下眼睑及内眦处无明显变化,无眼睑外翻、溢泪、内外眦变形、术后复发、下睑凹陷等并发症。术前与术后通过测量数据发现应用传统睑袋方法测量的距离在术后变化不明显,说明去除眶脂肪后,只是改变其下睑松弛和臃肿形态;而应用眶脂肪眶隔弓缘释放法术后的距离较术前减小,说明下睑凹陷区域被眶隔脂肪下移填平,凹陷区域得以改善,使面中部过渡区得以显现年轻化。结论:保留眶脂肪的眶脂肪眶隔弓缘释放睑袋整复术是应用弓缘释放法和眶区脂肪转移,这种手术方法是非常有效的方法,同时能使面部年轻化。结合被释放并下移的眶脂肪组织,充填于睑袋凹陷处,与单纯睑袋修复术相比,恢复自然形态。对于鼻颊沟、下眶缘沟及眶颊沟等沟槽畸形患者,较为适合这种手术。从解剖学角度解释成因,从面部衰老征象产生机制矫正睑袋畸形,使其更合理、自然,能够达到眶区面中部年轻化的效果。
[Abstract]:Objective: the traditional eyelid bag removal of orbital fat was simple, the lower eyelid pouch was simple to deal with, but the deformity of lacrimal groove in the middle transitional area was not improved. In this paper, the orbital fat orbital septal arch margin release lower eyelid bag restoration and traditional operation methods were compared. To study the clinical advantages of orbital fat orbital septal arch release in lower eyelid pouch restoration and the clinical effect of rejuvenation in the middle part of the eyelid. Methods: 36 patients with cosmetic surgery were selected. These patients were randomly divided into two groups, 18 cases in each group. One group was treated with traditional blepharoplasty, that is, orbital fat removal, and the other group was treated with orbital fat release method, which was based on blepharoplasty. According to the degree of skin relaxation, age, acceptance and so on, the two groups adopted transconjunctival approach or transdermal approach. The distance between the nasal tip and the vertical plane parallel to the face was measured at any point in the lower margin of the palpebral pouch. The changes of the distance before and after operation were compared and observed, and the statistical analysis was carried out. All patients were followed up within one year after operation. Results: from June 2009 to June 2010, 36 cases were followed up for 3 months to 1 year. It was found that the patients with traditional blepharoplasty were satisfied with the operation, the lower eyelid bloated shape was obviously improved, but the lacrimal groove depression was not obviously improved, and some patients' middle face skull-shaped aging form would gradually appear. All the patients treated with orbital fat release from orbital septum were satisfied with the results of the operation, the baggy appearance of lower eyelid disappeared or improved, the depression deformity of lower eyelid orbital margin sulcus, nasobuccal sulcus and orbital buccal sulcus were alleviated and resolved, and were obviously corrected and restored to nature. Round, plump lower eyelid outline. There were no obvious changes in the external angle, lower eyelid and inner canthus, no ectropion, tears, medial and medial canthus deformation, postoperative recurrence, lower eyelid depression and other complications. It was found that the distance measured by the traditional eyelid bag method was not obvious after operation, which indicated that the lower eyelid flabby and bloated only changed after the removal of orbital fat. However, the distance after the application of orbital fat orbital septal arcuate spell is smaller than that before operation, which indicates that the lower eyelid depression region is filled down by orbital septum fat, the depression area can be improved, and the transition area in the middle face will appear younger. Conclusion: orbital fat release blepharoplasty is a very effective method for orbital fat transfer and facial rejuvenation. The orbital adipose tissue, which was released and removed, was filled in the pouch of the eyelid and restored to its natural shape compared with the simple blepharoplasty. For patients with naso-buccal sulcus, inferior orbital sulcus and orbitobuccal sulcus, this operation is more suitable. To explain the cause of formation from anatomic point of view, to correct eyelid pouch malformation from the mechanism of facial aging sign, make it more reasonable and natural, can achieve the effect of the middle face of orbital area being younger.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6;R622

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