Maxillo-Facial Surgery Unit, Azienda Ospedaliera Universitaria "Ospedali Riuniti di Ancona" Umberto I, Ancona.
Department of Maxillo-Facial Surgery, University of Siena, Siena, Italy.
J Craniofac Surg. 2023;34(2):597-601. doi: 10.1097/SCS.0000000000008873. Epub 2022 Aug 11.
Traditional osteotomic procedures can fail to restore the natural appearance of the face and can sometimes highlight the intrinsic decrease in the volume of soft tissues; in these cases, soft-tissue-improving procedures should be considered. The authors describe a new strategy that can help redistribute facial soft tissues and enhance facial esthetics in orthognathic surgery using a pedicled buccal fat flap to increase the volume of the malar soft tissue envelope. Between January 2017 and January 2021, 47 patients with dentoskeletal deformity who needed to increase the projection of the cheekbone contour underwent orthognathic surgery with simultaneous pedicled buccal fat pad flap for malar augmentation. Preoperative and postoperative facial appearance was evaluated by clinical examination and analysis of photographs to assess the occlusal and esthetic outcomes. A patient questionnaire was used to assess self-evaluation satisfaction scores. A good projection of the cheekbone contour was obtained, and noticeable postoperative facial esthetic improvement was observed in all patients. The overall esthetic improvement was considered "excellent" by 89.36% of patients, and facial esthetic improvement was assessed as "very much improved" or "much improved" by the clinicians in 95.7% of cases. The buccal fat pad flap is a promising and easy technique in orthognathic surgery that helps harmonize the malar region; improve esthetic outcomes with predictable and lasting long-term stability; and ensure very low morbidity and great esthetic satisfaction.
传统的截骨术可能无法恢复面部的自然外观，有时还会突出软组织内在体积的减少；在这种情况下，应考虑软组织改善术。作者描述了一种新的策略，可以通过使用带蒂颊脂垫瓣来帮助重新分配面部软组织并在正颌手术中增强面部美感，从而增加颧骨软组织包的体积。2017 年 1 月至 2021 年 1 月期间，47 例需要增加颧骨轮廓突出度的牙颌面畸形患者接受了正颌手术，同时进行带蒂颊脂垫瓣用于颧骨增大。通过临床检查和照片分析评估术前和术后的面部外观，以评估咬合和美学效果。使用患者问卷评估自我评估满意度评分。所有患者均获得了良好的颧骨轮廓突出度，并且观察到明显的术后面部美学改善。89.36%的患者认为整体美学改善“优秀”，95.7%的病例临床医生评估面部美学改善为“明显改善”或“改善很多”。颊脂垫瓣是正颌手术中一种很有前途且简单的技术，有助于协调颧骨区域；改善美观效果，具有可预测且持久的长期稳定性；并确保非常低的发病率和极大的美学满意度。
