Cleveland, Ohio From the Departments of Plastic Surgery and Otolaryngology-Head and Neck Surgery, Case Western Reserve University, University Hospitals of Cleveland.
Plast Reconstr Surg. 2013 Nov;132(5):1085-1092. doi: 10.1097/PRS.0b013e3182a4c20a.
The purpose of this study was to identify the specific components of facial aging secondary to smoking, by comparing standardized photographs of identical twins with different smoking histories.
During the Twins Days Festival in Twinsburg, Ohio, from 2007 to 2010, 79 pairs of twins were identified, in which only one twin smokes or where one twin smoked at least 5 years longer than his or her counterpart. Questionnaires were obtained and standardized photographs were taken by professional photographers. A panel of three blinded judges analyzed the twins' facial features and graded wrinkles using the validated Lemperle Assessment Scale, and ranked age-related facial features on a four-point scale.
Smoking twins compared with their nonsmoking counterparts had worse scores for upper eyelid skin redundancy, lower lid bags, malar bags, nasolabial folds, upper lip wrinkles, lower lip vermillion wrinkles, and jowls. Lower lid hyperpigmentation in the smoking group fell just short of statistical significance. Transverse forehead wrinkles, glabellar wrinkles, crow's feet, and lower lip lines accentuated by puckering did not have a statistically significant differences in scores. Among twins with greater than 5 years' difference in smoking duration, twins who had smoked longer had worse scores for lower lid bags, malar bags, and lower lip vermillion wrinkles.
This study details the specifics of facial aging brought on by smoking, which primarily affects the middle and lower thirds of the face. It also demonstrates that a 5-year difference in smoking history can cause noticeable differences in facial aging in twins.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, II.
本研究旨在通过比较具有不同吸烟史的同卵双胞胎的标准照片，确定吸烟引起的面部衰老的具体特征。
2007 年至 2010 年期间，在俄亥俄州双胞胎节期间，我们在托纳万找到了 79 对双胞胎，其中只有一个双胞胎吸烟，或者一个双胞胎的吸烟史比他或她的双胞胎吸烟史长至少 5 年。我们获得了问卷调查表，并由专业摄影师拍摄了标准照片。一个由三位评审员组成的小组对双胞胎的面部特征进行了分析，并使用经过验证的 Lemperle 评估量表对皱纹进行了分级，还使用四分制对与年龄相关的面部特征进行了排序。
与不吸烟的双胞胎相比，吸烟的双胞胎的上眼睑皮肤冗余、下眼睑眼袋、颊袋、鼻唇沟、上唇皱纹、下唇红唇皱纹和下颌松弛的评分较差。吸烟组的下眼睑色素沉着评分接近统计学意义。额横纹、眉间纹、鱼尾纹和撅嘴时下唇线加深的评分没有统计学意义的差异。在吸烟时间相差超过 5 年的双胞胎中，吸烟时间较长的双胞胎的下眼睑袋、颊袋和下唇红唇皱纹评分较差。
本研究详细描述了吸烟引起的面部衰老的具体特征，这些特征主要影响面部的中下部。它还表明，吸烟史相差 5 年就会导致双胞胎的面部衰老出现明显差异。
临床问题/证据水平：风险，II。
