CAJ | 학술논문

目的探讨内镜除皱术与传统除皱术相结合的治疗方式及效果.方法仅存在额部皱纹、眉间纹及眉下垂者采用内镜额部除皱术,切除或切断皱眉肌、降眉肌和额肌,必要时结合额部皮瓣上提悬吊技术即可;如同时存在中下面部皮肤老化、松弛下垂,则内镜额部除皱术尚需结合传统切开法的中面部或中下面部除皱术,做浅表肌腱膜系统(SMAS)筋膜的折叠或切除缝合,以及多余皮肤的切除剪裁.结果 104例采用额部内镜除皱术,均取得良好的除皱和眉提升效果.并发症较少而轻微,包括表情肌去除部位的轻度凹陷、额部皮肤麻木、发际线轻微后移、皱纹去除不彻底等.无面神经颞支损伤等严重并发症发生.其中84例存在中下面部皮肤松弛下垂,在做内镜额部除皱的同时行耳前切口的传统除皱术,明显改善中下面部的皮肤老化,并使面部上下的年轻化协调一致.结论内镜额部除皱术设计合理、操作安全、效果明确,是一项切口小、损伤轻的微创技术,符合整形外科的发展趋势.对于同时存在有中下面部皮肤松弛者,如能结合传统切开法除皱术,面部年轻化的整体效果可进一步优化.
목적 탐토내경제추술여전통제추술상결합적치료방식급효과.방법 부존재액부추문、미간문급미하수자채용내경액부제추술,절제혹절단추미기、강미기화액기,필요시결합액부피판상제현조기술즉가;여동시존재중하면부피부노화、송이하수,칙내경액부제추술상수결합전통절개법적중면부혹중하면부제추술,주천표기건막계통(SMAS)근막적절첩혹절제봉합,이급다여피부적절제전재.결과 104례채용액부내경제추술,균취득량호적제추화미제승효과.병발증교소이경미,포괄표정기거제부위적경도요함、액부피부마목、발제선경미후이、추문거제불철저등.무면신경섭지손상등엄중병발증발생.기중84례존재중하면부피부송이하수,재주내경액부제추적동시행이전절구적전통제추술,명현개선중하면부적피부노화,병사면부상하적년경화협조일치.결론 내경액부제추술설계합리、조작안전、효과명학,시일항절구소、손상경적미창기술,부합정형외과적발전추세.대우동시존재유중하면부피부송이자,여능결합전통절개법제추술,면부년경화적정체효과가진일보우화.
Objective To investigate the techniques and signifcations of endoscopic forehead lift when it was done alone or in combination with conventional facelifting.Methods For the patients with forehead transverse wrinkle,vertical frown line and eyebrow ptosis,resection of partial frontalis muscle,procerus muscle and eorrugator muscle was performed.If the patients had obvious excessive and drooping skin in middle face and lower face together with the wrinkles that were mentioned above,endoscopic forehead lift in combination with conventional facelifting was done at the mean time.The excessive skin was tailored and removed,SMAS was complicated or resected and sutured.Results 104 patients were subjected to the endoscopic forehead lift,in which 20 cases underwent it alone,and another 84 cases were treated in combination with the conventional facelifting.Of all cases,104 patients presented satisfactory results of forehead.They showed the eliminating of transverse wrinkle of forehead,glabellas vertical fold and lifting of eyebrow ptosis.Complications were less and minimal,including minimal local depression,retrodisplacement of hairline of forehead,recurrence of wrinkle and numb of forehead.No injuring of temporal branch of facial nerve occurred in this group.The cases that underwent endoscopic forehead lift in combination with conventional faeelift showed the coordinate and consistence of rejuvenation from forehead to middle face and lower face.Conclusions Endoscopic forehead lift is a minimally invasive technique,and it presents more satisfactory results with less severe complications.Its operative principle is reasonable,procedure is safe and reliable,and therefore it represents the tendency of developing of plastic surgery and cosmetic surgery.If patients have obvious excessive and drooping skin in middle face and lower face,endoscopic forehead lift is suggested in combination with the conventional facelift,and this resolution shows more balanced and coordinate cosmetic correction of whole face.