Fernandes Julio Wilson
UNICENP Medical School, Rua Prof. Pedro Viriato Parigot de Souza, 5300 Curitiba, PR, Brazil.
Aesthetic Plast Surg. 2007 Sep-Oct;31(5):454-9; discussion 460-2. doi: 10.1007/s00266-006-0236-z.
The malar region has been a crucial target in many facial rejuvenation techniques because the beauty and youthful contour of a convex midface and a smooth eyelid-cheek sulcus are key features of a pleasing face-lift result. The full midface subperiosteal lift has helped to address these issues. However, the desire of patients currently for a rapid recovery and return to work with a natural-looking result has influenced procedural selection. Another concern is for safer procedures with reduced potential risk. Progressively fewer invasive techniques, such as the minimal access cranial suspension (MACS) lift, have been a response to these core concerns.
After 3 years of performing the conventional three purse-string suture MACS lift, the author developed a practical procedural modification. For a total of 17 patients, the author combined limited regional subperiosteal lift and periosteal fixation with a simple sling approach to the more fully released malar tissue mass to make a single-point suspension just above the lateral orbital rim.
The percutaneous sling lift appears to offer a degree and naturalness of rejuvenation of the malar region similar to those of the MACS lift and the full subperiosteal midface lift, but with fewer suspension points and less undermining. Also, the author observed less ecchymosis and edema than with the full midface subperiosteal lift, as would be expected. In all 17 cases, the need for the second and third purse-string sutures was eliminated.
The early results for the percutaneous sling lift indicate that it offers promising results, rapid recovery, and reduced risk of serious complications.
在许多面部年轻化技术中，颧部一直是关键目标，因为饱满的中面部和光滑的眼睑-脸颊沟所呈现出的美丽及年轻轮廓是面部提升效果令人满意的关键特征。全中面部骨膜下提升有助于解决这些问题。然而，当前患者希望快速恢复并能自然地重返工作岗位的需求影响了手术方式的选择。另一个关注点是寻求更安全、潜在风险更低的手术。诸如微创颅骨悬吊（MACS）提升术等侵入性逐渐减少的技术就是对这些核心关注点的回应。
在进行了3年传统的三荷包缝线MACS提升术后，作者开发了一种实用的手术改良方法。对于总共17例患者，作者将有限的局部骨膜下提升和骨膜固定与一种简单的悬吊方法相结合，对更充分松解的颧部组织块进行单点悬吊，悬吊点位于眶外侧缘上方。
经皮悬吊提升术似乎能提供与MACS提升术和全骨膜下中面部提升术相似程度和自然度的颧部年轻化效果，但悬吊点更少且剥离范围更小。此外，正如预期的那样，作者观察到与全中面部骨膜下提升术相比，瘀斑和水肿更少。在所有17例病例中，不再需要第二和第三道荷包缝线。
经皮悬吊提升术的早期结果表明，它能带来有前景的效果、快速恢复且严重并发症风险降低。
