Lee J S, Park W J, Shin M S, Song I C
Institute of Cosmetic and Plastic Surgery, Samsung Medical Center, Seoul, Korea.
Plast Reconstr Surg. 1997 Jul;100(1):170-8; discussion 179-81. doi: 10.1097/00006534-199707000-00027.
Conventionally, it has been argued that the aponeurosis meets the orbital septum below the upper tarsal border in Orientals. However, we have shown that the aponeurosis fused with the orbital septum above the upper tarsal border in 502 patients, which contradicts the classic concept. In 457 patients there were distinct layers of fascia anterior to the orbital septum that originate from the septum and insert onto the pretarsal aponeurotic expansion. In Oriental eyelids, the preaponeurotic fat and orbital septum hang below the fusion line of the septum and aponeurosis. The hanging portion of the septum was dissected from the aponeurosis, plicated, and sutured to the dermis of the pretarsal flap. We performed the septodermal fixation technique in 512 patients over 3 years starting in March of 1992. Complications and changes of the folds were analyzed. The technique produced much less edema and discomfort and created more natural fold lines than any other technique. Patients were very lightly satisfied with the shape of the folds that we were able to design and adjust precisely with this method.
传统观点认为，在东方人中，腱膜在睑板上缘下方与眶隔相连。然而，我们发现，在502例患者中，腱膜在睑板上缘上方与眶隔融合，这与经典概念相矛盾。在457例患者中，眶隔前方有明显的筋膜层，这些筋膜层起源于眶隔并附着于睑前腱膜扩展部。在东方人的眼睑中，腱膜前脂肪和眶隔悬垂于眶隔与腱膜的融合线下方。将眶隔的悬垂部分从腱膜上分离、折叠并缝合到睑前皮瓣的真皮上。从1992年3月开始的3年里，我们对512例患者实施了眶隔真皮固定技术。分析了并发症和褶皱的变化。与其他任何技术相比，该技术产生的水肿和不适更少，形成的褶皱线更自然。患者对我们能够用这种方法精确设计和调整的褶皱形状非常满意。
