睑袋整形术Hamra改良术式临床应用探析.docVIP

睑袋整形术Hamra改良术式临床应用探析[摘要]目的：探讨一种中老年睑袋的整形方法,以矫正中面部老化而出现的下睑皮肤松弛、眶隔脂肪堆积、沟槽畸形、颧部软组织松弛堆积及鼻唇沟加深的改变。方法：对286例睑袋采用Hamra（1995）改良术式，矫正中面部老化的睑袋外观畸形。结果：术后286例随访3月～4年，284例手术效果满意。下睑及颧骨前区皮肤松弛臃肿形态、沟槽畸形、鼻唇沟加深等症状得到明显改善，2例出现轻度下睑退缩。结论：对于中老年性睑袋外观畸形的沟槽畸形、颧骨前区皮肤松弛堆积、鼻唇沟加深等症状采用此法可使中面部老化得到较大的改善。 [关键词]睑袋；Hamra术；整形 [中图分类号]R622[文献标识码]A[文章编号]1008-6455（2008）08-1145-02 The clinical application of the lower eyelid blepharoplasty with modification Hamra skill LENG Kui-fang, GAO Jun-ming, ZHOU Peng-qi, LIU Zhong-ce, HUANG Wei (Department of Plastic and Cosmetic Surgery, Hangzhou Huashan Medical Aesthetic Hospital,Hangzhou 310016, Zhejiang, China) Abstract： ObjectiveTo explore the method of the lower baggy eyelid about the middle and old aged persons and to correct facial aging in skin relaxation of the lower eyelid, the orbital fat accumulation, “Tear trough deformity”, zygomatic soft tissue accumulation and relaxation, and nasolabial fold deepen.Methods286 cases of lower baggy eyelid were treaded with modification Hamra(1995)skill and improved the lower eyelid deformity of facial aging.Results286 cases were followed up for 3M-4Y, 284 cases were achieved satisfactory results. Lower eyelid and zygomatic soft tissue accumulation and relaxation, “Tear trough deformity”, nasolabial fold deepen have been improved.2 cases appeared slightly lower eyelid flinch.ConclusionThe aging of midface is greatly improved in the “Tear trough deformity” of the lower baggy eyelid ,and zygomatic soft tissue accumulation and relaxation ,and nasolabial fold deepen of middle and old aged persons. Key words：lower baggy eyelid;Hamra method;plastic 下睑袋整形术中单纯去除部分皮肤和眶脂肪，仅能使下睑的皱纹减少，臃肿外观改善，而新月形畸形、沟槽畸形、鼻唇沟加深形态不能得到明显改善，达不到求美者追求的年轻化形态。笔者2004年7月～2008年1月对286例患者采用Hamra改良术式，在传统改善下睑皱纹及臃肿态的同时改善沟槽畸形、新月形畸形及鼻唇沟过深，获得年轻化的效果。 1资料和方法 1.1 临床资料：本组286例，女275例，男11例，年龄42～66岁，均伴有下睑皮肤松弛，眶脂肪堆积颧部软组织松弛下垂，鼻唇沟加深，82例伴有眶颊、鼻颊沟槽状畸形 1.2 手术方法 1.2.1 切口设计：在下睑缘下1.5mm左右处，向内在下泪点处转向内下方3mm左右，向外外眦部沿第一鱼尾纹向外下方向延伸8mm左右。 1.2.2 手术操作：采用局部麻