Yu Panxi, Wu Qian, Wei Mengdie, Mao Xiaoying, Luo Yuna, Gu Tianyi, Huang Yuanliang, Zhao Minghao, Wang Yongqian, Zhang Chao, Lu Jianjian, Teng Li
Department of Craniomaxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Cleft Lip and Palate Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Aesthetic Plast Surg. 2024 Dec;48(24):5283-5291. doi: 10.1007/s00266-024-04429-9. Epub 2024 Oct 8.
A broad midface is usually accompanied by temporal depression. Traditional reduction malarplasty may visually improve the temporal depression by the inward reduction of zygomatic arch, but also has a high risk of soft tissue sagging. Our bracing technique has been reported to have an anti-sagging effect and may have a temporal augmentation effect as observed during our long-term clinical practice.
Data of patients who received reduction malarplasty with our bracing technique from September 2015 to July 2023 were retrospectively collected. The pre-op and post-op CT images of those who met the inclusion criteria were used for three-dimensional reconstruction and measurements of the thickness and volume of the temporal soft tissue as well as the elevation distance of zygomatic arch.
Fifty-eight patients with an average follow-up of 18.4 ± 9.1 months were included. Despite mild thinning of the temporalis muscle after reduction malarplasty, the overall thickness of the temporal soft tissue significantly increased due to the significant thickening of the temporal adipose-fascial layer. There was a 0.5 ml-increase in the temporal volume although without statistical difference. No significant correlation was detected between the elevation distance of zygomatic arch and the temporal thickness or volume change.
The bracing technique of reduction malarplasty not only plays an anti-sagging role, but also has a temporal augmentation effect through the superior bracing by the elevation and rigid fixation of the zygomatic arch. It adds brilliance to the traditional technique and can be suggested especially when the patients are disturbed by temporal depression.
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宽阔的中面部通常伴有颞部凹陷。传统的颧骨缩小成形术可通过向内缩小颧弓在视觉上改善颞部凹陷，但也有较高的软组织下垂风险。据报道，我们的支撑技术具有抗下垂作用，并且在我们的长期临床实践中观察到可能具有颞部增大效果。
回顾性收集2015年9月至2023年7月接受采用我们支撑技术的颧骨缩小成形术患者的数据。对符合纳入标准患者的术前和术后CT图像进行三维重建，并测量颞部软组织的厚度和体积以及颧弓的抬高距离。
纳入58例患者，平均随访18.4±9.1个月。尽管颧骨缩小成形术后颞肌轻度变薄，但由于颞部脂肪筋膜层显著增厚，颞部软组织的整体厚度显著增加。颞部体积增加了0.5ml，尽管无统计学差异。未检测到颧弓抬高距离与颞部厚度或体积变化之间存在显著相关性。
颧骨缩小成形术的支撑技术不仅起到抗下垂作用，还通过颧弓的抬高和牢固固定进行上支撑而具有颞部增大效果。它为传统技术增添了光彩，尤其当患者受颞部凹陷困扰时可推荐使用。
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