del Campo Antonio Fuente
Private practice in Mexico City, Mexico, USA.
Aesthet Surg J. 2008 Jan-Feb;28(1):51-61; discussion 62. doi: 10.1016/j.asj.2007.06.006.
The aging face is characterized by loss of skin elasticity, fat resorption, loss of muscle tone and volume, and loss of bone volume. Restorative procedures should be based on the condition of the soft tissues and the relationship between these tissues and the existing skeletal volume and can be performed through open, endoscopic, or minimally invasive approaches.
A minimally invasive approach to the face lift is presented, updated with useful details that the author has incorporated into his clinical technique on the basis of 15 years of experience.
The minimally invasive face lift is not a mini-lift but a full face lift performed through minimal incisions located in the frontal hairline, temporal area, triangular fossae of the auricle, submentalis, and eyelids. A wide dissection was performed to liberate the parietotemporal fascia from the zygomatic arch and to pull it up in continuity with the superficial musculoaponeurotic system and the platysma as one continuous layer or composite flap. These structures were selectively secured in a higher position, restoring the contour of the face and the consistency of the soft tissues.
The described procedures, or combinations of these procedures, were performed in 539 patients during a 9-year period. Preauricular incisions were avoided in 83% of cases. Complications were minimal and included temporary hypoesthesia of the forehead or cheek and temporary palsy of the frontotemporal branch of the facial nerve that resolved after 2 to 4 weeks. There were few problems with hematomas.
The minimally invasive face lift technique described here can reduce morbidity, achieve more durable results, and give a greater degree of satisfaction to patients. The procedures are relatively simple and easy to carry out but require somewhat of a learning curve to achieve optimal results.
衰老的面部特征为皮肤弹性丧失、脂肪吸收、肌肉张力和体积丧失以及骨量减少。修复手术应基于软组织状况以及这些组织与现有骨骼体积之间的关系，可通过开放式、内窥镜式或微创方法进行。
介绍一种微创面部提升方法，并更新了作者基于15年经验融入其临床技术的有用细节。
微创面部提升并非小型提升术，而是通过位于额发际线、颞部、耳廓三角窝、颏下和眼睑的微小切口进行的全面部提升。进行广泛剥离，将颞顶筋膜从颧弓松解，并将其与表浅肌肉腱膜系统和颈阔肌作为一个连续层或复合瓣向上牵拉。这些结构被选择性地固定在更高位置，恢复面部轮廓和软组织的紧致度。
在9年期间，对539例患者实施了所述手术或这些手术的组合。83%的病例避免了耳前切口。并发症极少，包括前额或脸颊的暂时性感觉减退以及面神经颞支的暂时性麻痹，2至4周后恢复。血肿问题很少。
本文所述的微创面部提升技术可降低发病率，取得更持久的效果，并使患者获得更高的满意度。这些手术相对简单且易于实施，但需要一定的学习曲线才能达到最佳效果。
