摘要目的 探讨软悬挂改良重睑术的应用效果.方法 2016年1月至2019年5月31日,浙江省人民医院整形外科收集500例患者,其中男19例,女481例(17～32岁).手术步骤根据传统术式改良,保留眼轮匝肌、游离出上睑提肌腱膜、并将两者缝合在一起,称为软悬挂术式.从患者中任意抽取40例,和40例传统重睑术一起进行问卷调查.结果 术后重睑形态和动态更接近天然重睑,满意度97.0％,有15例(3.0％)患者出现重睑线不对称、过窄和消失,均为上睑臃肿患者.软悬挂改良重睑术后满意度明显高于传统术式(x 2=8.658,P=0.003).术后肿胀、瘀血、瘢痕明显轻于传统术式;但术后出现不对称和重睑线变浅的比例高于传统术式.结论 软悬挂改良重睑术可取得比传统术式更自然的重睑形态,适用于上睑轻度臃肿的首次手术.

abstractsObjective The mechanism of traditional double-eyelid blepharoplasty is adhering skin to tarsus,by which the skin below the incision could be elevated along with the tarsus and produce the crease.But the anatomic basis of native double-eyelids is not the same,which depends on the connection of levator aponeuroses with muscle and skin.That is,the elevations of tarsus and skin is based on the different branches of levator aponeuroses to skin.According to this,the authors have developed a modified blepharoplasty suturing levator aponeuroses to the obicularis occuli muscle to mimic the native double eyelid.Methods The surgical procedures were modified from traditional surgery.The major improvements were:keeping obicularis occuli muscles intact,dissecting the levator aponeuroses and suturing them together.Since the suturing was performed between mobilized tissues of muscle and aponeurosis,the method was named as "flexible suspension technique".Five-hundred patients were performed with this method.Forty cases randomly selected from them were compared with 40 cases performed with traditional method,and the results were investigated using questionnaire survey.Results The results of the modified surgery were more natural than traditional technique.Majority of patients were satisfactory,whereas 15 cases (3％) had asymmetry,narrowing and even fold loss.All these 15 cases were puffy eyelids.Statistical results indicated that the satisfaction rate was significantly high (P =0.003),and the adverse effects (edema,bruise and scar) were significantly lighter than traditional technique;whereas the asymmetry and fold loss were higher than traditional technique.Conclusions The flexible suspension technique of blepharoplasty can obtain more natural double eyelid appearance,and is suitable for primary blepharoplasty but not applicable for severe puffy eyelids.