Prado Arturo, Andrades Patricio, Danilla Stefan, Castillo Paulo, Leniz Patricio
Division of Plastic Surgery, School of Medicine, Clinical Hospital J. J. Aguirre, University of Chilé, Santiago, Chile.
Plast Reconstr Surg. 2006 Apr 15;117(5):1413-25; discussion 1426-7. doi: 10.1097/01.prs.0000207402.53411.1e.
The purpose of this study was to retrospectively compare the short- and long-term cosmetic outcomes of two minimal incision rhytidectomies and analyze their advantages and disadvantages.
The results of minimal access cranial suspension face lift versus minimal incision rhytidectomy with lateral SMASectomy were evaluated after 1 and 24 months. Statistical analysis considered surgeon/patient satisfaction, time used in the procedures, pain, and learning curves. Photographs were sent to the patients and two plastic surgeons, unfamiliar with the cases, for evaluation of results that were assessed by an objective grading system described by Strasser.
Eighty-two patients completed 1 and 24 months' follow-up. Complications were two hematomas, two retroauricular-lobule dog-ears, and one hypertrophic preauricular scar. Surgical time was longer for the SMASectomy. Postoperative pain was worse for minimal access cranial suspension face lift. There were no differences in cosmetic results between the two techniques at 1-month and 2-year follow-up. Incorporating age, sex, postoperative pain, and duration of surgery as confounding factors did not modify the model. Surgeon/patient satisfaction showed no difference with either technique, but the photographic evaluation of all cases at 24 months revealed that more than 50 percent of the sample needed a tuck procedure to correct jowling and redundant skin.
Advantages of short-scar face lifts are the avoidance of the postauricular and occipital incisions, and the disadvantages are the moderate results in the neck and nasolabial folds and their potential short duration. For 24 months in this study, the duration of results was similar for both minimal access cranial suspension and lateral SMASectomy.
本研究的目的是回顾性比较两种小切口除皱术的短期和长期美容效果，并分析其优缺点。
在术后1个月和24个月评估微创颅骨悬吊面部提升术与小切口除皱术联合外侧SMAS切除术的效果。统计分析考虑了外科医生/患者的满意度、手术时间、疼痛和学习曲线。将照片发送给患者和两名不熟悉病例的整形外科医生，由他们根据Strasser描述的客观分级系统评估结果。
82例患者完成了1个月和24个月的随访。并发症包括2例血肿、2例耳后-耳垂皮赘和1例耳前肥厚性瘢痕。SMAS切除术的手术时间更长。微创颅骨悬吊面部提升术的术后疼痛更严重。在1个月和2年的随访中，两种技术的美容效果没有差异。将年龄、性别、术后疼痛和手术时间作为混杂因素纳入分析并未改变模型。外科医生/患者的满意度在两种技术之间没有差异，但在24个月时对所有病例的照片评估显示，超过50%的样本需要进行收紧手术来纠正下颌赘肉和皮肤冗余。
短瘢痕面部提升术的优点是避免了耳后和枕部切口，缺点是颈部和鼻唇沟的效果一般且可能持续时间较短。在本研究中，24个月时，微创颅骨悬吊术和外侧SMAS切除术的效果持续时间相似。
