Rousso Daniel E, Brys Agata K
Rousso Facial Plastic Surgery Clinic, Birmingham, Alabama 35223, USA.
Facial Plast Surg. 2011 Feb;27(1):67-76. doi: 10.1055/s-0030-1270424. Epub 2011 Jan 18.
A patient presenting to a facial plastic surgeon with lower eyelid aging often has accompanying midface descent. Many surgical options exist to address these deformities. Blepharoplasty techniques include both the transcutaneous skin-muscle flap as well as the transconjunctival approach. The midface can be addressed via a multitude of techniques, including percutaneous suspension of the malar fat pad, deep plane dissections, subperiosteal and endoscopic midface lifts, and transorbital approaches. Patients who have some midface ptosis but do not meet the standard criteria for formal midface lifting, or who want to avoid the extended recovery associated with such techniques, could benefit from less invasive procedures. We propose the extended skin muscle blepharoplasty to address midface descent and lower lid aging to patients as an alternative to formal midface lifting. The extended skin muscle blepharoplasty is an excellent technique for patients with orbicularis hypertrophy, skin redundancy, a tear trough deformity, and premalar ptosis, as it addresses each of these deformities with minimal downtime. Results for patients with mild but visible midface descent are gratifying.
前来面部整形外科医生处就诊的下睑衰老患者通常伴有中面部下垂。有多种手术选择可用于解决这些畸形问题。睑成形术技术包括经皮肤的皮肤-肌肉瓣法以及经结膜入路。中面部可通过多种技术进行处理，包括经皮悬吊颧脂肪垫、深层平面剥离、骨膜下和内镜下中面部提升以及经眶入路。对于那些有一定程度的中面部下垂但不符合正式中面部提升标准的患者，或者那些希望避免此类技术相关的较长恢复时间的患者，可能会从侵入性较小的手术中获益。我们提出采用扩展皮肤肌肉睑成形术来解决患者的中面部下垂和下睑衰老问题，作为正式中面部提升的替代方法。扩展皮肤肌肉睑成形术对于眼轮匝肌肥大、皮肤冗余、泪沟畸形和颧前下垂的患者是一种极好的技术，因为它能以最短的停工期解决所有这些畸形问题。对于有轻度但明显中面部下垂的患者，效果令人满意。
