Résumé
Objective:To explore the clinical effect of the middle facial rejuvenation by cutting off the tear trough ligament and the orbicularis retaining ligament complex, opening the soft tissue spaces, combined with the lower eyelid muscle flap lateral canthus periosteum suspension and the orbital septum fat release.Methods:The clinical data of 39 patients with pouch and lacrimal groove, eyelid buccal groove depression in the Department of Cosmetic Surgery, Chongqing Chengshang Medical Beauty Clinic from June 2018 to June 2019 were retrospectively analyzed, including 2 males and 37 females, aged 30-58 (39±7) years. Through the incision of lower eyelid margin, the tear trough ligament and the orbicularis retaining ligament were completely severed. Up on the periosteum blunt, the preseptal, premaxillary and the prezygomatic spaces were dissected, and thus the fat of orbital diaphragmatic was fully expanded, by moving down and fixing on the inside, midside and outside periosteum of the inferior edge of the orbital bone. The lower eyelid muscle flap was suspended on the lateral canthus periosteum at the same time.Results:The patients were followed up for 12 months, the pouch, lacrimal groove and eyelid buccal groove depression were solved, the ptosis tissue of middle face was restored well and the effect was lasting. 3 patients felt the external eye angle traction after operation, and the symptoms disappeared 3-4 weeks later. 1 patient had mild eyelid ball separation due to hematoma organization after operation, and symptoms disappeared 3 months after anti scar treatment.Conclusions:For patients with pouch, lacrimal groove depression, eyelid buccal groove depression and midface tissue ptosis, the operation can safely and effectively solve the above problems and achieve the purpose of rejuvenation of the middle face, which is worthy of clinical application.
Résumé
Objective:To evaluate the clinical effect of autologous nanofat combined with pearl fat transplantation in comprehensive improvement of lacrimal groove depression.Methods:Seventy-eight patients (age ranges from 28 to 56 years, with average 38 years) who desired for lacrimal groove improvement were involved in this study from Jan. 2019 to Jun. 2020 in the Department of Plastic Surgery in Peking Union Medical College Hospital. Primary fat tissue was obtained and purified by liposuction. Nanofat and pearl fat were prepared and injected into lacrimal groove area in different layers and multiple points evenly to ameliorate depression. Visual analogue scoring (VAS) was used for evaluating injection pain. Dark eye circles, faint lines on lower eyelid, color spots and lacrimal groove depression between pre-operation pictures and post-operation pictures of 1 year follow-up were evaluated by patients＇ satisfaction scores.Results:All 78 patients revealed mild swelling and disappeared in 3 to 4 days. Injection areas were stable in 3 months. All patients appeared no complications such as infection, hematoma, fat liquefaction, local induration and so on. Among 78 patients, 2 patients showed ecchymosis after surgery which disappeared in 10 days, and 1 patient showed uneven appearance which disappeared after timely treatment. After 1 year of follow-up, the average satisfaction score of improvement was 8.9±0.5, which showed satisfied post-operative effect.Conclusions:Autologous nanofat combined with pearl fat transplantation has high feasibility, short operation time, which could achieve good effect of facial rejuvenation with high patients＇ satisfaction. In this case, this technique is worthy of clinical promotion.