摘要
目的研究确定人颧颊部皮下组织层次中脂肪组织层形态结构及其固定形式;探索面中下部年轻化手术方法。方法①尸体标本颧颊部被覆软组织结构解剖学研究;②以PTFE线作为悬吊材料,采用"佛手"式颧颊纤维脂肪垫连续悬吊,矫正面中下部老化性松垂形态。结果解剖学研究显示,面中下部皮下组织层中存在不同于脂肪组织的脂肪与纤维的混合结构组织层-纤维脂肪垫层。其分布于颧颊部的皮下脂肪层和SMAS层之间,分隔了SMAS层与皮肤的联系。该层与皮肤以规律密集的"篱笆"样短小纤维韧带致密连结,与SMAS层及深部组织间以簇状粗大"真性韧带"及"幕墙"样纤维韧带疏松连结。牵动纤维脂肪垫结构,可带动其上皮肤同步移动从而影响面中下部形态,而牵动SMAS层则不能有效地移动表层皮肤。临床应用"佛手"式颧颊纤维脂肪垫悬吊术矫正老年面中下部松垂172例,其中27例随访1年, 11例随访2年,效果满意。结论颧颊部皮下组织中存在纤维脂肪垫层,该层又可分为两部分,即颧纤维脂肪垫和颊纤维脂肪垫。该纤维脂肪垫层是形成面中下部衰老形态的主要结构层次。也是影响SMAS层上提面中部效果的主要原因。以PTFE线"佛手"式连续悬吊颧颊纤维脂肪垫上提手术,可同时均匀上提面中下部、睑外侧部软组织,从而有效地改善面中下部老化松垂的形态。用1-0 PTFE线进行悬吊可以减少"切割"现象,延长手术效果的维持时间。
Objective To investigate the anatomic characteristics of the subcutaneous layers of the zygomaticobuccal area and to explore a new method for facial rejuvenation. Methods ①Anatomic study on cadaveric soft tissue covering zygomaticobuccal region was carried out. ②Zygomaticobuccal fibrofatty pads were continuously suspended with 1 - 0 PTFE thread in the shape of a Buddha＇s hand to correct the aging tissue relaxation. Resuits Between the subcutaneous layer and the SMAS layer there is a layer consisting of fat and fiber in the middle and lower parts of the face, which form a link between SMAS layer and skin. It can be called the fibrofatty pad layer and it has a tight link with the skin by tiny fence- like fibers but a looser linkage with SMAS and deeper structures by ligaments and screen- like fibers. Moving the fibrofatty pad upwards can change its form and accordingly change the appearance of the middle and lower parts of the face, whereas the same effects is not observed when the SMAS layer is lifted. A total of 172 cases were operated by this method. 27 cases had one year follow up and 11 cases were followed for two years. The aesthetic results were good. Conclusion A fibrofatty layer exists under the zygomaticobuccal skin and it consists of two parts： the zygomatic fibrofatty pad and the buccal fibrofatty pad, based on location. This fibrofatty layer is the main structure involved in the aging appearance of the middle and lower face, which is the main reason for the effects of SMAS lifting. The laxation of ageing can be apparently improved by zygomaticobuccal fibrofatty pad suspension in the shape of a Buddha＇s hand with 1 - 0 PTFE thread. Using the PTFE thread can reduce the ＇cutting＇ phenomenon and make the operative improve-ment more durable.
出处
《中国美容整形外科杂志》
CAS
2007年第6期414-418,共5页
Chinese Journal of Aesthetic and Plastic Surgery
关键词
面中下部
纤维脂肪垫
“佛手”式连续悬吊
Middle and lower face
Fibrofatty pad
Buddha＇s hand - shaped continuous suspension
