摘要目的:探讨采用自体真皮填充上唇美学单元的临床效果。方法:回顾性分析2022年1月至2024年7月南京市第二医院整形外科收治的上唇形态不佳患者的临床资料。在臀部骶尾区做一长约5.0 cm的纵向梭形切口，切取所需真皮组织，根据填充位置对真皮进行修剪塑形，用于红唇增厚者修剪成梭形，填充人中嵴时修剪为扁平条索状；在上唇红唇正中央做长约0.5 cm的纵向切口，在口轮匝肌和唇黏膜之间的平面向两侧口角分离(填充红唇)，或向人中嵴分离(填充人中嵴)，形成隧道，将真皮组织填充于隧道中；对于唇珠不明显者，可在唇珠处适当叠加真皮。术后观察患者切口愈合、并发症发生情况，对上唇红唇、人中嵴形态进行随访，调查患者对手术效果是否满意。结果:共纳入11例患者，均为女性，年龄19~57岁，平均38.1岁。其中，7例患者采用真皮组织填充了上唇红唇，3例填充了上唇红唇和人中嵴，1例进行上唇提升术的同时填充了人中嵴。除1例合并唇珠不明显者采用2层真皮叠加填充唇珠区外，其他病例均为单层真皮填充。术后随访6~17个月，术后早期患者唇部会出现肿胀，2周后可改善；术后切口均一期愈合，无血肿及感染等并发症发生。上唇红唇外观平滑自然、触感柔软，红唇饱满度、上唇前突度、唇珠及人中嵴立体感等均明显改善，未发生真皮挛缩、囊肿及其他远期并发症，患者对上唇形态均较满意。结论:采用自体真皮填充上唇美学单元，可有效改善上唇形态，远期效果稳定，并发症少，患者满意度高。

abstractsObjective:To explore the clinical effect of upper lip aesthetic unit filled with autogenous dermis.Methods:The clinical data of patients with poor upper lip morphology admitted to the Department of Plastic Surgery of the Second Hospital of Nanjing from January 2022 to July 2024 were analyzed retrospectively. A longitudinal fusiform incision was made approximately 5.0 cm long in the sacrococcygeal region; the required dermal tissue was excised; and the dermis was trimmed and shaped according to the filling location. For thickening the vermilion border, the dermis was trimmed into a fusiform shape. For filling the philtral columns, the dermis was trimmed into a flat strip shape. A longitudinal incision (approximately 0.5 cm) was made in the center of vermilion. Then the tissue was separated in the layer between the orbicularis oris muscle and the mucosa to the direction of oral commissure (filling the vermilion) or separated to the philtrum ridge (filling the philtrum ridge), forming a tunnel and filling the dermal tissue in the tunnel. For subtle vermilion tubercle, the dermis could be overlapped and filled in an appropriate location in vermilion tubercle. The incision healing and complications were observed, and the morphology of upper lip and philtrum ridge was followed up to investigate whether the patients were satisfied with the surgical outcomes.Results:A total of 11 patients, all female, aged 19-57 years (mean, 38.1 years) were included. In 7 patients, the upper lip was filled with dermal tissue, the upper lip and the philtrum ridge were filled in 3 cases, and the upper lip lifting was performed in 1 case with philtrum ridge. Except for one case where the vermilion tubercle was not prominent and a two-layer dermal overlay was used to fill the vermilion tubercle, all other cases received single-layer dermis filling. The patients were followed up for 6 to 17 months. The lip swelling occurred in the early postoperative period, which could be improved after 2 weeks. The incisions were healed primarily, and no complications such as hematoma and infection occurred. The appearance of the upper lip was smooth, natural and soft. The fullness of the upper lip, the protuberance of the upper lip, the stereopsis of the vermilion tubercle and the philtrum ridge were significantly improved. No dermal contracture, cyst or other long-term complications occurred. All patients were satisfied with the appearance of upper lip.Conclusion:The use of autologous dermis to fill the upper lip aesthetic unit can effectively improve the upper lip apperance, with stable long-term results, fewer complications and high patient satisfaction.