Matarasso Alan, Wallach Steven G, Difrancesco Lisa, Rankin Marlene
Plastic Surgery, Albert Einstein College of Medicine, Manhattan, Eye, Ear, & Throat Hospital, New York, NY, USA.
Aesthet Surg J. 2002 Nov;22(6):526-30. doi: 10.1067/maj.2002.129827.
Statistics published by The American Society for Aesthetic Plastic Surgery report a 48% increase in cosmetic procedures for 2000-2001 and a 14% increase for rhytidectomies alone. Patients aged 35 to 50 account for 30.2% of all rhytidectomies performed. Many of these patients undergo secondary rhytidectomy.
We investigated differences between patients undergoing secondary rhytidectomy and those undergoing a primary rhytidectomy, and between older (more than 60 years) and younger (60 years or less) patients undergoing secondary rhytidectomy.
A retrospective descriptive research design with the computer cross-filing system of the senior author (A.M.) was reviewed for patients undergoing secondary or more (ie, tertiary, quaternary, etc) rhytidectomy. A total of 113 consecutive patients were identified; charts from 98 female patients and 3 male patients, were available for review. Ages at the time of surgery ranged from 40 to 81 years, with an average of 60.
Among patients older than 60 undergoing secondary face lift, 41 of 53 patients (77%) had combined procedures with their most recent face lift; 39 of 53 (74%) of these patients had at least one comorbid medical condition. Among patients aged 60 or younger undergoing secondary face lift, 37 of 48 patients (77%) underwent multiple procedures along with their most recent face lift, and 16 of 48 patients (33%) had at least one comorbid medical condition. The overall complication rate was 2/101 (2%).
There is a statistically significant increase in the number of comorbid medical conditions in older patients. The overall complication rate in patients undergoing secondary rhytidectomy compares favorably to that traditionally quoted for patients undergoing primary rhytidectomy, who on average are younger at the time of surgery. This suggests that in properly screened patients, even in older patients with combined ancillary procedures, secondary face lifting is both common and safe. (Aesthetic Surg J 2002;22:526-530.).
美国美容整形外科学会公布的数据显示，2000 - 2001年美容手术数量增长了48%，仅除皱手术就增长了14%。35至50岁的患者占所有除皱手术的30.2%。这些患者中有许多人接受二次除皱手术。
我们调查了接受二次除皱手术的患者与接受初次除皱手术的患者之间的差异，以及年龄较大（60岁以上）和年龄较小（60岁及以下）的接受二次除皱手术的患者之间的差异。
采用回顾性描述性研究设计，利用资深作者（A.M.）的计算机交叉存档系统，对接受二次或更多次（即三次、四次等）除皱手术的患者进行审查。共确定了113例连续患者；其中98例女性患者和3例男性患者的病历可供审查。手术时年龄范围为40至81岁，平均年龄为60岁。
在60岁以上接受二次面部提升手术的患者中，53例患者中有41例（77%）在最近一次面部提升手术时同时进行了其他手术；这些患者中有39例（74%）至少有一种合并内科疾病。在60岁及以下接受二次面部提升手术的患者中，48例患者中有37例（77%）在最近一次面部提升手术时进行了多项手术，48例患者中有16例（33%）至少有一种合并内科疾病。总体并发症发生率为2/101（2%）。
老年患者合并内科疾病的数量在统计学上有显著增加。接受二次除皱手术患者的总体并发症发生率与传统上报道的接受初次除皱手术患者的并发症发生率相比更有利，初次除皱手术患者手术时平均年龄更小。这表明，在经过适当筛选的患者中，即使是进行了联合辅助手术的老年患者，二次面部提升手术也很常见且安全。（《美容外科杂志》2002年；22:526 - 530。）
