Hamra S T
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Plast Reconstr Surg. 1998 Oct;102(5):1646-57. doi: 10.1097/00006534-199810000-00051.
Composite rhytidectomy added the repositioning of the orbicularis oculi muscle to the deep plane face lift to achieve a more harmonious appearance of the face by adding periorbital rejuvenation. By not separating the orbicularis oculi from the zygomaticus minor and by extending the dissection under medial portions of the zygomaticus major and minor muscles, a more significant improvement in composite rhytidectomy can now be achieved. A thin nonrestrictive mesentery between the deep plane face lift dissection and the zygorbicular dissection still allows vertical movement of the composite face lift flap without interrupting the intimate relationship between the platysma, cheek fat, and orbicularis oculi muscle. This modification eliminates the occasional prolonged edema and occasional temporary dystonia previously observed. It allows the continuation of the use of the arcus marginalis release, which has also been modified by resetting the septum orbitale over the orbital rim. These two modifications allow a more predictable and impressive result. They reinforce the concept of periorbital rejuvenation as an integral part of facial rejuvenation, which not only produces a more harmonious immediate result but prevents the possible unfavorable sequelae of conventional rhytidectomy and lower blepharoplasty.
复合除皱术在深层平面面部提升术中增加了眼轮匝肌的重新定位，通过增加眶周年轻化来实现面部更和谐的外观。不将眼轮匝肌与小颧肌分离，并在大、小颧肌内侧部分下方延长剥离范围，现在可以在复合除皱术中取得更显著的改善效果。在深层平面面部提升剥离和眶周剥离之间存在一层薄的无限制系膜，这仍允许复合面部提升皮瓣进行垂直移动，而不会中断颈阔肌、颊脂肪和眼轮匝肌之间的紧密关系。这种改良消除了之前偶尔出现的长时间水肿和偶尔的暂时性肌张力障碍。它允许继续使用边缘弓释放术，该技术也通过将眶隔重新置于眶缘上进行了改良。这两种改良带来了更可预测且令人印象深刻的效果。它们强化了眶周年轻化作为面部年轻化不可或缺一部分的概念，这不仅能立即产生更和谐的效果，还能预防传统除皱术和下睑成形术可能出现的不良后遗症。
