个性化处理SMAS层面部年轻化手术.docVIP

个性化处理SMAS层面部年轻化手术 　　[摘要]目的：总结并探讨各种通过SMAS个性化处理达到面部年轻化的除皱手术方法。方法：回顾研究56例面部老化患者的治疗过程，根据患者自身老化程度，行相应区域的SMAS广泛剥离，并以不同方式个性化处理SMAS层，达到对面部软组织年轻化重塑的手术方法和术后效果。结果：术后随访6月～2年，面部软组织均获得显著的年轻化效果，术后56例患者均较满意。结论：根据患者自身的老化程度，以不同方式个性化处理 SMAS层的面部年轻化手术，是安全有效的软组织提升方法，可达到除皱术更为持久的年轻化效果。 　　[关键词]浅表肌肉腱膜系统；面部老化，面部提升术；除皱术 　　[中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2012）03-0362-03 　　 　　Personal- tightening superficial musuclo-aponeurotic system for face lift 　　HOU Dian-ju,FANG Lin,LI Bin-bin,LV Wei,YANG Ming-yong 　　(The 14th Plastic Department of Plastic Surgery Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100144,China) 　　 　　Abstract: Objective To summarize and discuss the effect of superficial muscle aponeurosis system personal-tightening in face lift. Methods The treatment process of 56 patients of personal SMAS-suspended rhytidectomy were reviewed retrospectively. According to themselves aged degree, the SMAS flap was firstly elevated,then personal tightened by different methods such as cut out or plicate in the operation . We analyzed and evaluated the surgical operative procedure and treatment results of this personal-tightening SMAS rhytidectomy. Results 56 patients underwent personal-tightening, SMAS-suspended and remodeling rhytidectomy. All the followed-up cases obtained good results without complications. Conclusion The personal-tightening SMAS rhytidectomy according to patientsdifferent aging degree is a valuable and safe method to treat face aging with low invasion and long-lasting aesthetic results. 　　Key words:SMAS(superficial musculo-aponeurotic system)；face aging; face lift; rhytidectomy 　　 　　 从Miller和Kolle首次提出直接切除皮肤去除皱纹来改善老化征象至今已100余年。随着人们对面颈部老化机制的理解及面部解剖学研究的深入，除皱术的手术方法也在不断的发生变化。从20世纪60年代流行的面颈部皮下分离的第一代除皱术，到始于1976年的SMAS（superficial musculo-aponeurotic system, 表浅肌肉腱膜系统）理论的提出，此后开始了针对SMAS悬吊提升为主流的第二代除皱术，1982年Tessier提出面上1/3骨膜下剥离除皱的理论，开始了对第三代除皱术式的探讨。但目前对骨膜下除皱的术后远期效果还存在争议，且该方法去除皮肤量不足，较适合于老化现象较轻的患者。对于大部分中老年患者面部老化征象的矫正，目前仍以第二代除皱术为主流, 将SMAS剥离并提紧