Hou Wen-ming, Chen Lu-ping, Xu Da-chuan
Department of Plastic Surgery, Zhujiang Hospital, First Military Medical University, Guangzhou 510282, China.
Di Yi Jun Yi Da Xue Xue Bao. 2003 Apr;23(4):375-6, 379.
To study the new surgical approach to repair depressed deformity of the upper eyelids by transferring brow fat pad flap that retains blood supply and similar construction with the orbital septum.
An incision was made in the inferior margin of the brow to dissect and expose the brow fat pad under the orbicular muscle of the eye and frontal muscle plane in the lateral superior orbit, and the flap was removed from above the periosteum and pedicled under the orbital rim. Through the incision in the double-eyelid fold, a tunnel was dissected upward from the plane under the orbicular muscle to reach the brow incision. The brow fat pad flap was then turned over to cover the deformity, followed by fixation and suture of the flap and a double-eyelid operation.
Four patients with the upper eyelid deformity were successfully treated using this new procedure with satisfactory results and no complications were encountered. Fat absorption was not observed in the one-year follow-up.
This procedure has the merits that (1) the fat tissue transferred to the recipient site has blood supply, thus fat absorption is prevented and the surgical results can be almost permanently maintained; (2) The similarity between the construction of the brow fat pad and the orbital septum fat may ensure better result with more natural look of the eyelids; (3) The donor site is adjacent to the recipient site to facilitate the brow fat pad transferring; (4) The operation leaves no obvious scars at the donor site.
研究通过转移保留血供且结构与眶隔相似的眉脂肪垫瓣修复上睑凹陷畸形的新手术方法。
在眉下缘做切口，在眼眶外上侧眼轮匝肌与额肌平面下解剖暴露眉脂肪垫，在骨膜上方掀起瓣并在眶缘下带蒂。通过双眼皮皱襞处的切口，从眼轮匝肌下平面向上分离出一条隧道直至眉部切口。然后将眉脂肪垫瓣翻转覆盖畸形部位，接着对瓣进行固定缝合并做双眼皮手术。
4例上睑畸形患者采用该新方法治疗成功，效果满意，未出现并发症。随访1年未观察到脂肪吸收。
该手术方法具有以下优点：（1）转移至受区的脂肪组织有血供，可防止脂肪吸收，手术效果几乎可永久维持；（2）眉脂肪垫与眶隔脂肪结构相似，可确保更好的效果，使眼睑外观更自然；（3）供区与受区相邻，便于眉脂肪垫转移；（4）手术在供区不留下明显瘢痕。
