Yaremchuk Michael J
Aesthetic Plast Surg. 2005 May-Jun;29(3):141-7; discussion 148. doi: 10.1007/s00266-004-0139-9. Epub 2005 Jun 3.
Inadequate projection of the midface skeleton results in midface concavity. Patients with this skeletal morphology tend to have prominent eyes and noses. Lack of skeletal support for the midface soft tissue envelope predisposes to premature cheek descent, resulting in palpebral fissure distortion and lower lid "bags," an appearance of early aging. Concave midfaces can be made convex with two basic maneuvers performed through intraoral and periorbital incisions. Midface skeletal projection can be increased by augmenting the facial skeleton with alloplastic implants. Multiple implants are required to replicate the complex curvature of the midface skeleton and to avoid impingement on the infraorbital nerve. Subperiosteal elevation of the midface soft tissues and repositioning provides cheek fullness and narrows the palpebral fissure while masking eyelid "bags." The resultant midface concavity makes the eyes and nose appear less prominent. This procedure has been a safe and effective treatment for 14 patients treated over a 4-year period.
面中部骨骼投影不足会导致面中部凹陷。具有这种骨骼形态的患者往往眼睛和鼻子较为突出。面中部软组织包膜缺乏骨骼支撑易导致脸颊过早下垂，从而引起睑裂变形和下睑“眼袋”，呈现出早衰的外观。通过经口内和眶周切口进行的两种基本操作可使凹陷的面中部变得凸出。可通过植入异体材料来增大面部骨骼，从而增加面中部骨骼投影。需要多个植入物来复制面中部骨骼的复杂曲率，并避免压迫眶下神经。面中部软组织的骨膜下提升和重新定位可使脸颊丰满，缩小睑裂，同时掩盖眼睑“眼袋”。由此产生的面中部凹陷使眼睛和鼻子看起来不那么突出。在4年期间，该手术对14例患者而言是一种安全有效的治疗方法。
