Lee Y, Kim J H
Department of Plastic and Reconstructive Surgery, Seoul National University, College of Medicine, Chongno-Gu, Korea.
Plast Reconstr Surg. 1999 Sep;104(4):1165-71; discussion 1172-3.
Correcting facial asymmetry is a difficult problem for plastic surgeons. From 1991 to 1996, the authors treated 53 cases of mandibular angle resection, 13 of which were of patients with an asymmetrical lower face. On the basis of these experiences, the authors highlight two important points in dealing with the asymmetrical lower face. The first is accurate resection of each side of the face. A cloth pattern was used to improve the accuracy of the procedure and to make the final result match the preoperative design regarding amount and shape. The second concerns soft-tissue change after the operation. Satisfactory results are obtained by the accurate resection of the bone coupled with the correct management of the surrounding soft tissue. The amount of bone to be resected was determined not simply by cephalometry, but by both cephalometry and external appearance. Postoperative cephalometry is not always symmetrical, and it is important that the final external appearance be harmonious and symmetrical. Using the above method, results have been satisfactory to both the surgeons and the patients, with the exception of three patients who had residual asymmetry. No permanent sensory loss or motor nerve palsy was observed, and no infections occurred.
对于整形外科医生来说，矫正面部不对称是一个难题。1991年至1996年，作者治疗了53例下颌角切除术患者，其中13例为面部下半部不对称患者。基于这些经验，作者强调了处理面部下半部不对称的两个要点。第一是精确切除面部两侧。使用布样来提高手术的准确性，并使最终结果在量和形状上与术前设计相匹配。第二涉及术后软组织的变化。通过精确切除骨头并正确处理周围软组织可获得满意的效果。要切除的骨头量并非仅由头影测量法决定，而是由头影测量法和外观共同决定。术后头影测量并不总是对称的，重要的是最终的外观要和谐对称。使用上述方法，除了3例仍有残余不对称的患者外，外科医生和患者都对结果感到满意。未观察到永久性感觉丧失或运动神经麻痹，也未发生感染。
