London and Glasgow, United Kingdom From King Edward VII's Sister Agnes Hospital.
Plast Reconstr Surg. 2012 Dec;130(6):1317-1327. doi: 10.1097/PRS.0b013e31826d9f7f.
The longevity of face-lift surgery is a key question that has not been adequately addressed by previous studies. No study has used standardized photographs, objective measurements, or validated subjective scoring systems.
From 2001 to 2011, photographs were standardized in this institution. Fifty primary face-lift patients were assessed 5.5 years after surgery using objective measurements from standardized photographs, a region-specific subjective assessment (Scale Summit II scores), and an overall subjective assessment (Global Aesthetic Improvement Scores).
For the first outcome measure, the jowl elevated in vertical height by 6 mm after face-lift surgery, with a relapse of 21 percent at 5.5 years. Jowl correction was maintained at 5.5-year follow-up (p < 0.0001). Cervicomental angle decreased by 13 degrees after face-lift surgery, with partial relapse of 69 percent at 5.5 years. For the second outcome measure, scores showed significant improvement in all areas following a face lift (jowl, nasolabial, and marionette, p < 0.0001; neck, p = 0.0007). At 5.5 years, no subjective worsening of any area was noted except the neck. For the third outcome measure, scoring suggested that 76 percent of patients will still appear younger 5.5 years after a face lift than they did before the face lift.
This study indicates that differential regional aging occurs after face lifting, with the jowl, nasolabial, and marionette areas remaining well corrected at 5.5 years but with partial relapse of neck correction. Long-term global aesthetic assessment remains positive in the vast majority of patients. This study provides strong evidence that face-lift surgery can provide significant long-term aesthetic gains.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
拉皮手术的持久效果是一个尚未被以往研究充分探讨的关键问题。既往研究均未使用标准化照片、客观测量或经验证的主观评分系统。
本机构自 2001 年至 2011 年采用标准化照片。50 例初次行面中部提升术患者,在术后 5.5 年时采用客观的标准化照片测量、特定区域的主观评估(Scale Summit II 评分)和整体主观评估(总体美学改善评分)进行评估。
对于第一个结果测量指标,面中部提升术后 6 个月时颏下区垂直高度提升 6mm,5.5 年时复发率为 21%。5.5 年随访时颏下区仍保持矫正效果(p<0.0001)。面中部提升术后颈颏角减小 13°,5.5 年时复发率为 69%。对于第二个结果测量指标,面中部提升术后所有区域的评分均显著改善(颏下区、鼻唇沟区和木偶纹区,p<0.0001;颈部,p=0.0007)。5.5 年时,除颈部外,所有区域均未出现主观恶化。对于第三个结果测量指标,评分提示 76%的患者在面中部提升术后 5.5 年仍比术前看起来更年轻。
本研究表明面中部提升术后出现的是差异性的区域性老化,5.5 年时颏下区、鼻唇沟区和木偶纹区仍保持良好的矫正效果,但颈部的矫正效果部分复发。绝大多数患者的长期整体美学评估仍呈阳性。本研究有力地证明了面中部提升术能带来显著的长期美学效果。
临床问题/证据等级:治疗性,IV 级。