Department of Plastic & Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.
Department of Plastic Surgery, Tian Tan Pu Hua Hospital, Shanghai, China.
J Craniofac Surg. 2021;32(1):179-183. doi: 10.1097/SCS.0000000000007043.
With aging, the facial contour shows a double-concave deformity. Conventional facial contouring procedure, including face lifting and fat grafting, cannot yield a smooth facial contour line. This study was the first to propose a combination of reduction malarplasty and 2nd-stage autologous fat grafting so as to achieve the aesthetic goals of facial contour rejuvenation.
The study group comprised patients seeking facial contour rejuvenation from January 2017 to May 2018 (28 patients: 28 females and 0 males) at the Department of Plastic Surgery, Tian Tan Pu Hua Hospital. All of the cases underwent bilateral malarplasty with 2nd-stage autologous facial fat grafting. Radiologic and photographic documentation was completed preoperatively. The mean follow-up period was 12 months. Patients' pre-op photographs and 3 months follow-up pictures were blindly assessed.
Most of the patients were satisfied with their results after 1-time fat grafting. Eleven patients demanded re-injection after the 1st fat grafting in temporal area, and 6 patients demanded 3rd time fat grafting in temporal area. Eleven patients demanded re-injection insubmalar area, and 8 patients demanded 3rd time fat grafting in submalar area. Meanwhile, 9 of those patients underwent fat grafting in other sites other than temporal and submalar region. The amount of fat injected was also recorded in this study. The appearance of double-concave deformity was greatly improved in all cases. Complications included infection (3.6%), hematoma (7.1%), and malar prominence relapse (7.1%), and so on.
Reduction malarplasty combined with several times of fat grafting could effectively overcome the malar prominence and soft tissue deflation. Complications were minimal after these procedures. Therefore, this technique is useful to restore the youthful facial contour in Asian patients with aging double-concave deformity.
随着年龄的增长，面部轮廓呈现出双凹畸形。传统的面部轮廓整形手术，包括面部提升和脂肪移植，都无法获得平滑的面部轮廓线。本研究首次提出了颧骨缩小术和二期自体脂肪移植相结合的方法，以达到面部轮廓年轻化的美学目标。
本研究组包括 2017 年 1 月至 2018 年 5 月在天坛普华医院整形科寻求面部轮廓年轻化的患者（28 例：28 例女性，0 例男性）。所有患者均行双侧颧骨缩小术和二期自体面部脂肪移植术。术前完成影像学和照片记录。平均随访时间为 12 个月。对患者的术前照片和 3 个月的随访照片进行了盲法评估。
大多数患者在 1 次脂肪移植后对结果满意。11 例患者在颞区第 1 次脂肪移植后要求再次注射，6 例患者在颞区要求第 3 次脂肪移植。11 例患者在颧下区要求再次注射，8 例患者在颧下区要求第 3 次脂肪移植。同时，9 例患者在颞区和颧下区以外的部位进行了脂肪移植。本研究还记录了注射的脂肪量。所有患者的双凹畸形外观均得到了明显改善。并发症包括感染（3.6%）、血肿（7.1%）和颧骨突出复发（7.1%）等。
颧骨缩小术联合多次脂肪移植可有效矫正颧骨突出和软组织萎缩。这些手术的并发症较少。因此，该技术对于恢复亚洲衰老性双凹畸形患者的年轻面部轮廓是有用的。
