摘要
近年来在欧美取代传统的除皱术，以最小限度的皮肤切口，利用关节镜进行表情肌的悬吊，即内窥镜除皱术正在广泛兴起。但是，有人强调东方人的皮肤特征及审美观与欧美人有差别。在此我们对东方人面部老化状态进行分类设计手术方案。前额部以上提肌与下制肌的形态分为三类。①上提肌紧张为伸展皮肤行帽状腱膜下剥离；②上提肌弛缓时为提升眉行骨膜下剥离；③下制肌紧张时行下制肌切除。颊部以皮肤、筋膜与皮下脂肪的状态进行分类。有皮肤松弛者行广泛皮下剥离，多余皮肤切除。无皮肤松弛的筋膜松弛者，在内窥镜下行耳前的ＳＭＡＳ筋膜分离提升。皮下脂肪堆积者行颊部及颧部的脂肪吸引。麻醉采用局部麻醉并用镇静剂。使用器械为直径４ｍｍ的硬性内窥镜辅以电视显示系统。在内窥镜直视下分离至眶缘、颧弓上、腮腺前缘浅层，要注意勿损伤皮神经及面神经，对分离后的筋膜以及骨膜以尼龙线进行悬吊。然后，用罗丝钉固定于前额部颅骨。由于使用了内窥镜，我们的除皱病人猛增。１９９４年７月至１９９８年８月共进行了前额除皱１６５例，颞部除皱２９例，颊部除皱９７例，全面部除皱７０例，总计为３６１例。
Recently, endoscopic facelift has been taking the place of conventional open lift. In consideration of the peculiarity of Oriental skin and their aesthetic sense, I have modified the procedure and the surgical instruments. I employed the Olympus Endoscopic System which is composed of a light source, monitor, and a rigid 4 milimeter arthroscope with 30 degree angle. I classify the forehead condition preoperatively into Hyper-levator type(hyper-activity of frontalis), Hypo-levator type (hypo-activity of frontoea), and hyper-depreaser type (hyper -activity of corrugaror procerus). The forchcad skin is undermincd subgalcally on Hyper-levawr to stretch the frontalis, and subperiosteally on hypo-levator to reposition lowset eyebrows. On Hyper-depresser, the procerus and corrugator are exciscd. After complete dissection, the forehead skin is suspended with micro-screw fixation. Check condition is also classiflud into Redundant skin type. Drooping SMAS type, and Excessive fat type. Temple and check are dissected heneath temporo-parietalis and SMAS respectively. Drooping SMAS is lifted up with fascial sutures. Redundant skin has to be excised at preauricular region. Excessive fat is aspirated through sub-lobular incision. The number of endolift from July. 1994 to August, 1998 totaled 361 cases which composed of 165 cases of forahead lift. 29 cases of temporal lift, 97 cases of lower face lift, 70 cases of total face lift, and several cases of combination with open face lift, liposuction, and osteotomy. There is less swelling, numbness, and scar formation than conventional open lift. The undermining layer and muscle excision adapted to the forehead condition and combined operation at cheek area make Orientals a feasible indication of endolift.
出处
《实用美容整形外科杂志》
1999年第1期48-50,共3页
Journal of Practical Aesthetic and Plastic Surgery
关键词
内窥镜
除皱术
东方人
美容整形外科
Endoscopy, Facelift, Orientals, Aesthetic plastic surgery
