Trussler Andrew P, Kawamoto Henry K, Wasson Kristy L, Dickinson Brian P, Jackson Eric, Keagle Jennifer N, Jarrahy Reza, Bradley James P
Los Angeles, Calif. From the Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at the University of Los California, Los Angeles.
Plast Reconstr Surg. 2008 Mar;121(3):1024-1032. doi: 10.1097/01.prs.0000299383.82723.ec.
Lip augmentation is used to enhance a thin upper lip or correct lip deficiencies. The palmaris longus tendon, an accessory tendon of the wrist, has been used successfully for upper extremity reconstruction and was used in this case series for upper lip augmentation.
Patients underwent upper lip augmentation using palmaris longus tendon grafts at the University of California, Los Angeles from 1998 to 2005 (n = 38). Vertical lip height, lateral lip projection, and dynamic smile length were measured preoperatively, at 6 weeks, and at 1-year follow-up, and complications, lip mobility, and physician/patient outcome surveys were recorded.
Palmaris graft lip augmentation was performed for cosmetic (n = 21) and reconstructive (n = 17) indications. There were two infections and two graft exposures, with no long-term sequelae. The vertical height of the upper lip had a mean increase of 204 percent and a mean relapse of 9 percent (change from postoperative period to follow-up). Lateral projection of the upper lip showed a mean increase of 180 percent and a relapse rate of 7 percent. Dynamic lip mobility had a mean grade of 4.7 of 5 at 1 year, and the postoperative smile length was close to the preoperative length (mean postoperative length was 96 percent of preoperative length). One patient developed a stiff upper lip and required reoperation and therapy for a good final outcome.
The authors' case series shows that the palmaris longus tendon provides a reliable option for soft-tissue upper lip augmentation, with improved vertical height and lateral projection and maintenance of lip mobility.
唇部填充用于改善上唇过薄或矫正唇部缺陷。掌长肌腱是腕部的一条副肌腱，已成功用于上肢重建，并在本病例系列中用于上唇填充。
1998年至2005年期间，加利福尼亚大学洛杉矶分校的患者（n = 38）接受了使用掌长肌腱移植物的上唇填充术。在术前、术后6周和1年随访时测量垂直唇高、外侧唇突度和动态微笑长度，并记录并发症、唇部活动度以及医生/患者的结果调查。
掌长肌腱移植物唇部填充术用于美容（n = 21）和重建（n = 17）适应症。发生了2例感染和2例移植物外露，无长期后遗症。上唇垂直高度平均增加204%，平均复发率为9%（从术后到随访的变化）。上唇外侧突度平均增加180%，复发率为7%。1年时动态唇部活动度平均评分为4.7（满分5分），术后微笑长度接近术前长度（术后平均长度为术前长度的96%）。1例患者出现上唇僵硬，需要再次手术和治疗才能获得良好的最终效果。
作者的病例系列表明，掌长肌腱为软组织上唇填充提供了一种可靠的选择，可改善垂直高度和外侧突度，并保持唇部活动度。
