下颌角弧形截骨联合SMAS悬吊面部提升术.doc

下颌角弧形截骨联合SMAS悬吊面部提升术[摘要]目的：探讨经除皱术耳前切口行下颌角弧形截骨并同时悬吊SMAS层提升面中部的手术方法。方法：回顾研究9例下颌角肥大的治疗过程，分析并总结采用耳前切口入路行下颌角弧形截骨，同时行SMAS层悬吊的面中部除皱术，对面部骨骼及软组织年轻化重塑的手术方法和术后效果。结果：术后随访6个月～2年，面部的骨骼及软组织均获得显著的年轻化效果，术后9例患者均较满意。结论：下颌角弧形截骨联合SMAS悬吊的面部提升术，在改变面部骨性轮廓的同时，最大限度的提升了面部松弛的软组织，是同时对面部骨骼和软组织年轻化重塑的理想方法。 [关键词]下颌角弧形截骨；SMAS；面部提升术；面部整形 [中图分类号]R62 R782 [文献标识码]A [文章编号]1008-6455（2012）02-0213-03 Combined surgery of mandibular angle ostectomy with SMAS-suspended facial rhytidectomy FANG Lin,HOU Dian-ju,YANG Ming-yong (The 14th Plastic Department of Plastic Surgery Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100144,China) Abstract: Objective To explore a new method for the curved ostectomy of mandibular angle and simultaneously correction of soft tissue laxity by preauricular incision approaching. Methods The treatment process of 9 patients of mandibular angle hypertrophy were reviewed retrospectively, analyzed and evaluated the surgical operative procedure and treatment results of Combined Surgery of the curved ostectomy of mandibular angle with SMAS-suspended rhytidectomy. Results 9 patients treated with this new method(underwent the curved ostectomy of mandibular angle and SMAS-suspended rhytidectomy by preauricular approaching).All the followed-up cases obtained good results. Conclusion This new method can not only modify the facial skeleton contour, but also correction the soft tissue loss.It is a relatively ideal surgical method of facialplasty for those aged patients with mandibular angle hypertrophy. Key words:the curved ostectomy of mandibular angle;SMAS;rhytidectomy;facialplasty 下颌角弧形截骨术的常规方法采用口内入路。术后容易出现皮肤松垂的问题。对于年龄大的患者更容易出现。因此笔者思考一种下颌角截骨的同时进行皮肤软组织松垂矫正的手术方法，对于年龄大的患者，除皱效果更加彻底。在2009年8月～2011年4月，笔者进行了9例经口外入路下颌角弧形截骨，同时行SMAS悬吊的面部提升手术，在矫正下颌角肥大的同时，进行最大限度的面部提升术。这是一种同时对面部骨骼和软组织年轻化重塑的理想方法。 1 资料和方法 1.1临床资料：本组共9例患者，均为女性，年龄35～55岁，平均42岁，均为发育性下颌角肥大，伴不同程度的面部软组织松垂，手术均出于美容目的。所有患者在全麻下行口外入路双侧下颌角弧形截骨术及面部除皱术，其中4例行全颜面+颈部除皱术，3例行次全颜面除皱术，2例行中面部除皱术。全部病例咬