Hamra S T
Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, USA.
Plast Reconstr Surg. 1998 Oct;102(5):1658-66. doi: 10.1097/00006534-199810000-00052.
Traditional face lift and blepharoplasty techniques are based on two consistent principles. Conventional face lift techniques have always incorporated unopposed lateral vector tissue advancement, which is typical of subcutaneous lifts or rhytidectomies that include the platysma muscle (SMAS) or cheek fat (malar fat). When they are not adequately repositioned, the tissues of the lower eyelid and upper cheek continue to age, which may create a "lateral sweep" of the lower face as those malar soft tissues descend at a more rapid rate than the repositioned SMAS. Removal of the lower eyelid fat in conventional blepharoplasties may also lead to a more hollow-appearing lower eyelid. Hollow eyes and the lateral sweep could be prevented with a rhytidectomy technique that includes orbicularis repositioning and preservation of the lower eyelid fat with an arcus marginalis release. All patients who have been operated on who exhibit these unfavorable signs can have an impressive correction by utilizing the principles of superomedial vector orbicularis repositioning to counter the "lateral sweep" and arcus marginalis release to recreate a youthful shallow and narrow lower eyelid contour. This technique is invaluable to patients seeking secondary surgery to regain harmony of the rejuvenated face.
传统的面部提升术和眼睑成形术基于两个一致的原则。传统的面部提升技术一直包含无对抗的侧向矢量组织推进，这是皮下提升术或除皱术中典型的操作，这些手术包括颈阔肌（SMAS）或颊脂（颧脂肪）。当它们没有得到充分重新定位时，下眼睑和上脸颊的组织会继续老化，随着那些颧部软组织比重新定位的SMAS下降得更快，可能会导致下脸出现“侧向下垂”。传统眼睑成形术中去除下眼睑脂肪也可能导致下眼睑看起来更凹陷。通过一种包括眼轮匝肌重新定位和通过边缘弓释放保留下眼睑脂肪的除皱术，可以预防眼窝凹陷和侧向下垂。所有接受过手术且出现这些不良体征的患者，通过运用上内侧矢量眼轮匝肌重新定位的原则来对抗“侧向下垂”，并通过边缘弓释放来重塑年轻的浅而窄的下眼睑轮廓，都可以得到令人印象深刻的矫正效果。这项技术对于寻求二次手术以恢复年轻化面部和谐的患者来说非常宝贵。
