摘要目的 探讨面部组织出现松弛和下垂者,采用综合措施改善面部软组织轮廓和曲线的手术方法.方法 对257例应用面颊部浅表肌腱膜系统(SMAS)和脂肪组织多点密集荷包缝合收紧,改善中下面部张力；采用睑袋手术同时提升鼻唇沟,以改善鼻唇沟加深的程度f采用面颊部和下颌脂肪抽吸,以改善下面部轮廓横径变宽和下颌线曲线不流畅.结果 257例中获随访50例,随访3～60个月,面部组织松弛下垂的情况得到明显改善,鼻唇沟变浅,面部软组织轮廓曲线流畅,下颌线显现明显,下面部轮廓变窄,脸部明显瘦削,受术者对手术效果满意.术后无血肿发生,无神经损伤等严重并发症.2例在手术后1年内因为体重的大幅度减轻而出现面部明显消瘦,年轻化效果不明显而再次手术,术后年轻化效果在随访期内满意.结论 面部年轻化综合手术安全、有效,并且效果持久、稳定.

abstractsObjective To explore a method for reconstruction of the middle and lower facial tension system for surgical rejuvenation.Methods From 2003 to 2011,257 female patients were treated with this procedure,in which superficial musclo-aponeurotic system (SMAS) of the cheeks were tightened and fixed to the deep temporal fascia and the temporal muscle fascia in muhidirectional and oblique toward the eye and ear rather than just toward the ear through purse string suture method to achieve the goals of facial rejuvenation.Results The follow-up data were obtained in 50 cases,with time range of 3-60 months.Each case was evaluated by both the patient and the surgical team.Excellent or good results were achieved for 255 cases.In all we succeeded in correcting the nasolabial sulcal deformity,and the cheek ptosis,and the contour of the face were more smoothly than that of preoperative appearance.The outlines of lower face became narrow,and thinner than the preoperative.All the patients were without loss of facial identity.Complications occurred occasionally,including the tensional blister on the dermal suture point and local numbness.No incision scar,alopecia and facial nerve injury occurred.Effects of rejuvenation were obvious and natural in 3-6 months after surgery.Especially 12 months after operation the results were the best.Conclusions This technique addresses the multiple factors involved in the senescent changes of the midface.Proper patient selection,good aesthetic judgment,and surgical competence are required to restore the midface and lower face tension system reconstruction.This novel approach is safe and effective,and the result is stable and lasting.