Aesthet Surg J. 2024 Apr 4;44(5):473-481. doi: 10.1093/asj/sjad378.
Midcheek lift has been performed for cosmetic or reconstructive surgery of the lower eyelid. For midcheek lift through the subciliary incision, preperiosteal and subperiosteal dissections are the most often implemented, with good clinical outcomes. However, a comparative assessment of the effects of these 2 methods had not been conducted.
In this study we compared the effects of midcheek lift according to preperiosteal or subperiosteal plane and range of midfacial dissection.
Forty hemifaces of 20 fresh cadavers were dissected. One side of the hemiface underwent preperiosteal dissection, and the other side underwent subperiosteal dissection. After dissections of 5, 10, 15, 20, and 30 mm and all of the midcheek area from the inferior orbital rim, the length of the elevated lid-cheek junction was measured by placing upward traction on the lateral portion of the lower lid.
In both methods, the length of the midcheek lift increased as the dissection progressed, and the length of the lift on the lateral side was greater than that on the medial side. The length of the pulled skin in the preperiosteal group was the greatest in most cases. However, in the full dissection cases, the midcheek lift length was not statistically different between the 2 surgical methods, especially on the lateral side.
Flap elevation in lower blepharoplasty surgery can be predicted based on the surgical method and dissection range. Implementing a surgical plan that takes this into account can enhance both reconstruction and aesthetic surgery outcomes in the midcheek area.
中面部提升术已被应用于下眼睑的美容或重建手术。对于经眶下切口的中面部提升术，经骨膜前和骨膜下剥离是最常实施的方法，具有良好的临床效果。然而，这两种方法的效果尚未进行比较评估。
本研究比较了经骨膜前平面和骨膜下平面以及中面部剥离范围的中面部提升术的效果。
对 20 具新鲜尸体的 40 侧半面进行解剖。半面的一侧行骨膜前剥离，另一侧行骨膜下剥离。在从眶下缘到整个中面部进行 5、10、15、20 和 30mm 的剥离后，通过对下眼睑外侧部分施加向上的牵引力来测量提升的眼睑-面颊交界处的长度。
在两种方法中，随着剥离的进行，中面部提升的长度增加，外侧的提升长度大于内侧。在大多数情况下，骨膜前组的皮瓣提升长度最大。然而，在全层剥离的情况下，两种手术方法的中面部提升长度无统计学差异，特别是在外侧。
根据手术方法和剥离范围，可以预测下眼睑成形术的皮瓣提升。考虑到这一点制定手术计划，可以提高中面部重建和美容手术的效果。
