Meloplication of the malar fat pads by percutaneous cable-suture technique for midface rejuvenation: outcome study (392 cases, 6 years' experience).
Meloplication of the malar fat pads by percutaneous cable-suture technique for midface rejuvenation: outcome study (392 cases, 6 years' experience).
复制标题
经皮线绳缝合技术切除颧骨脂肪垫以实现中面部年轻化：结果研究（392例，6年经验）。
DOI：
10.1097/00006534-200208000-00042
复制
发表时间：
2002
影响因子：
3.6
通讯作者：
A. Cohen
中科院分区：
文献类型：
--
作者：
Gordon Hiroshi Sasaki;A. Cohen
通过逆转颧骨脂肪垫复合体向鼻唇沟下垂所产生的轮廓起伏来恢复老化的前中面。不规则的凸起包括后中隔脂肪的暴露、颧骨袋的暴露和鼻唇沟的突出。凹陷的不规则性表现为眼睑-面颊交界处的月牙形凹陷、鼻轭沟突出和鼻唇沟加深。下垂的颧骨脂肪垫的重新定位，在其他元素的meloplasty，是一个关键的程序。在这项研究中，颧骨脂肪垫已被定义为一个扇形结构的外部解剖标志，密切相关的尸体解剖和临床病例的结果，证实了螺旋CT扫描的结果。资深作者（G.H.S.）在过去6年中开发了一种简单但功能强大的可调节且持久的经皮缝线抬高技术。以将脂肪垫重新定位在上外侧方向。通过鼻唇沟内的点状切口，永久性CV-3 Gore-Tex（或4-0透明Prolene）悬吊缝线穿过Gore-Tex锚移植物，沿垂直于鼻唇沟的方向悬吊颧骨脂肪垫。第二个悬吊系统同样通过另一个较低的点切口，以扩大颧骨脂肪垫上的重新定位向量。从鼻唇沟点切口测量，每对缝线末端的张力将颧骨脂肪垫抬高1至3 mm。缝线通过Gore-Tex翼片固定在颞深筋膜上，有效稳定软组织复位。这种手法可以在年轻的病人谁提出了一个孤立的颧骨脂肪垫上睑下垂没有多余的面部皮肤。该手术也可用于开放式除皱术，以解决这一沿着的浅表肌肉腱膜系统收紧的问题。自1995年以来，共有392例患者接受了颧骨脂肪垫缝合提升术。一项结局研究表明，自1998年以来，使用两种永久性缝线和Gore-Tex锚移植物，面中部年轻化改善超过82%。早期和晚期并发症发生率较小且为暂时性。患者的接受度非常好，这表明了颧骨脂肪垫复合体解剖复位的益处。
The aging anterior midface is restored by reversing the contour undulations produced by sagging of the malar fat pad complex toward the nasolabial line. The convex irregularities include the exposed bulges of the post-septal fat, the unveiled malar bag, and the prominent nasolabial fold. The depressed irregularities are represented by the cresent-shaped hollow at the lid-cheek junction, the accentuated nasojugal groove, and the deepening nasolabial line. Repositioning of the ptotic malar fat pad, among other elements of meloplasty, represents a key procedure. In this study, the malar fat pad has been defined as a fan-shaped structure by external anatomic landmarks that correlate closely to the findings in cadaveric dissections and clinical cases, confirmed by the findings of spiral computed tomographic scanning. A simple but powerful adjustable and long-lasting percutaneous suture elevation technique was developed over the past 6 years by the senior author (G.H.S.) to reposition the fat pad in a superolateral direction. Through a dot incision within the nasolabial line, a permanent CV-3 Gore-Tex (or 4-0 clear Prolene) suspension suture, looped through a Gore-Tex anchor graft, suspends the malar fat pad in a direction perpendicular to the nasolabial line. A second suspension system is identically passed through another lower dot incision to broaden the repositioning vectors on the malar fat pad. Tension on each of the paired suture ends elevates the malar fat pad by 1 to 3 mm as measured from the nasolabial dot incisions. The sutures are fixed to the deep temporal fascia through a Gore-Tex tab, effectively stabilizing the soft-tissue repositioning. This maneuver may be performed in younger patients who present with an isolated malar fat pad ptosis without excess facial skin. The procedure may also be incorporated into open rhytidectomies to address this recalcitrant area along with superficial musculoaponeurotic system tightening. A total of 392 patients since 1995 underwent suture elevation of the malar fat pads. An outcome study indicated that the usage of two permanent sutures with Gore-Tex anchor grafts since 1998 resulted in improvement in midface rejuvenation of over 82 percent. Early and late complication rates were small and temporary. Patient acceptance was excellent, indicative of the benefits of anatomic repositioning of the malar fat pad complex.