Erol O O
Department of Plastic and Reconstructive Surgery at Kadir Has University, and Vehbi Koç Foundation American Hospital of Istanbul, Turkey.
Plast Reconstr Surg. 2000 Nov;106(6):1375-87; discussion 1388-9. doi: 10.1097/00006534-200011000-00026.
Facial aging is both a physiologic and anatomic process characterized by changes in the skin and supporting tissues. The aging process produces an outer envelope that gradually expands while its contents gradually involute and the underlying structure weakens. This process results in an excess of skin that tends to create folds, grooves, and deepening furrows. Contour augmentation and filling depressions with autologous tissue or heterogeneous materials are widely used in face rejuvenation as an adjunctive procedure. There is unanimous agreement on the advantages of autogenous tissue grafts over alloplastic materials and heterogeneous transplants. It is also well known that the revascularization of a small graft (fat, dermis, and/or composite graft) is better than a large graft. For this reason, fat injections consisting of small particles have recently become popular. According to different authors, a graft take may vary from 30 to 50 percent. Nevertheless, it has been thoroughly documented that a graft consisting of dermis or fascia is superior to a fat graft in both the graft take rate and quality of the tissue. Strips of dermal graft have been used successfully for several years to fill lip contour and nasolabial folds. However, the main disadvantage of this technique is that utilization is restricted only to certain areas where there is a need for a small incision. To overcome this obstacle, the author developed a simple technique to obtain an injectable mass from a mixture of dermis, muscle strips, fat tissue, and fascia to use in body contouring (especially in the facial region) in large areas. The author describes the use of the technique in 450 patients. Follow-up in these patients from 6 months to 10 years showed that the application of the "tissue cocktail" procedure in select patients improved the author's results and created a marked increase in the number of satisfied patients with no complaints. The take and durability of this kind of graft were superior to the author's results using fat grafts. The tissue cocktail graft remained stable for several years, as effectively seen in the chin region. The sole complication from the procedure was some bruising, which was resolved in several days. No single infection or inclusion cyst was observed in this series.
面部老化是一个生理和解剖学过程，其特征是皮肤和支持组织发生变化。衰老过程产生一个外部包膜，其逐渐扩张，而其内容物逐渐退化，底层结构变弱。这个过程导致皮肤过多，容易形成褶皱、沟纹和加深的皱纹。使用自体组织或异种材料进行轮廓增强和填充凹陷作为辅助手术在面部年轻化中被广泛应用。对于自体组织移植相对于异体材料和异种移植的优势，人们达成了一致共识。众所周知，小移植体（脂肪、真皮和/或复合移植体）的血管再生优于大移植体。因此，由小颗粒组成的脂肪注射近来变得流行起来。根据不同作者的说法，移植成活率可能在30%至50%之间。然而，已有充分文献证明，由真皮或筋膜组成的移植体在移植成活率和组织质量方面均优于脂肪移植体。真皮移植条已成功使用数年，用于填充唇部轮廓和鼻唇沟。然而，该技术的主要缺点是其应用仅限于需要小切口的特定区域。为克服这一障碍，作者开发了一种简单技术，从真皮、肌肉条、脂肪组织和筋膜的混合物中获取可注射物质，用于大面积身体塑形（尤其是面部区域）。作者描述了该技术在450例患者中的应用。对这些患者6个月至10年的随访表明，在特定患者中应用“组织混合液”手术改善了作者的治疗效果，显著增加了满意且无投诉患者的数量。这种移植体的成活率和持久性优于作者使用脂肪移植体的效果。组织混合液移植体在数年中保持稳定，在下巴区域可以明显看到。该手术唯一的并发症是一些瘀伤，数天内即可消退。在该系列中未观察到任何感染或包涵囊肿。
