组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2024, Vol. 20 ›› Issue (5): 542-.

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脂肪胶联合手术一期改善中老年女性上睑衰老的经验

  

  • 出版日期:2024-10-08 发布日期:2024-11-25

The clinical efficacy of blepharoplasty combined SVF-gel grafting for upper eyelid rejuvenation in Asian mid-aged and elderly female

  • Online:2024-10-08 Published:2024-11-25

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摘要：

　目的　探讨上睑精细化注射脂肪胶结合手术，以改善中老年女性上睑松弛凹陷的可行性。方法　本研究针对
214例进行重睑术及ROOF层SVF-gel脂肪填充的患者进行回顾性研究。所有患者均在局麻下行腹部脂肪抽吸术及重
睑术，采用正量填充法，将备好的脂肪胶用25 g钝针分层微滴状注射于设定范围内的眼轮匝肌与骨膜层之间，随后行上
睑松弛矫正术（即重睑术），主要采用“桥式”固定术，充分释放眶隔脂肪并去除多余皮肤和轮匝肌。患者术前、术后当日
和术后 6个月时均拍摄标准照片，同时进行患者上睑凹陷美学评估、满意度评分及术后效果评价。术后效果评价包括
凹陷改善，重睑对称及并发症发生情况。结果 214例患者，均为女性，平均年龄（38.61±10.22）岁，术后随访6~23个月，
平均（12.36±3.132）个月。所有患者都接受了双侧的重睑术配合脂肪胶填充，填充容量每侧 1.2~2 mL，平均（1.535±
0.282） mL。最后整体的上睑凹陷美学比例为3.569±1.517，较术前1.115±0.502（n=428，P＜0.000 1）增大，表明上睑凹陷
改善。GAIS评分为2.384±0.193（n=214）。仅有14例（6.54%）患者出现术后7 d内的血肿，并在两周内完全缓解。术后6
个月，仍有47例（21.96%）患者上睑凹陷改善不足，要求进一步填充以达到更好的效果，再手术率为21.96%。大部分患
者对手术效果满意，患者平均满意度为（3.974±0.473）分（满分5分）。结论　脂肪胶联合重睑手术可安全地改善中老年
女性上睑松弛及凹陷；脂肪胶在上睑的精细化填充中有较好的疗效。

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Abstract:

Objective To explore the feasibility of SVF-gel fat grafting to sunken upper eyelid combined with
blepharoplasty to improve upper eyelid laxity and depression in middle-aged and elderly women. Methods In this study，
214 patients who underwent blepharoplasty and ROOF layer SVF-gel fat filling were retrospectively studied. All patients
underwent abdominal liposuction and blepharoplasty under local anesthesia， and the SVF-gel was injected into the layers
between orbicularis oris muscle and periosteum layer of designed grafting area in the form of micro-droplets in ROOF layers
by using 25g blunt needles， finished by overcorrection of sunken upper eyelid. The laxity of upper eyelid was then corrected
by blepharoplasty with bridge skill， fully released septum fat and removed the appropriate amount of skin as well as muscle.
Standard photos were taken before and on the day after surgery，6 months after surgery， and aesthetic evaluation of upper
eyelid depression， satisfaction score and postoperative effect evaluation were also performed. Postoperative effect evaluation
included improvement of depression， double eyelid symmetry and complications. Results The 214 patients were all female，
with an average age of （38.61±10.22） years. The overall follow-up period was 6 to 23 months， and the average follow-up
period was （12.36±3.132） months. All the patients underwent bilateral blepharoplasty with SVF-gel fat grafting to ROOF 
layer， the amount of fat grafting ranged from 1.2-2 mL on one side， mean （1.535±0.282） mL on one side. The final overall
ratio of upper eyelid depression scored 3.569±1.517， while the preoperative ratio scored 1.115±0.502（n=428，P<0.000 1），
indicating a significant improvement in upper eyelid depression. The GAIS score was 2.384±0.193 （n=214）. Only 14
（6.54%） patients presented with hematomas within 7 days of surgery which resolved completely within two weeks. Eventually
at six months after surgery，47（21.96%） patients still had insufficient improvement of the upper eyelid depression and
required secondary fat grafting to achieve a better result， with a reoperation rate of 21.96%. Majority of patients were satisfied
with the results of the procedure， with an average satisfaction score of （3.974±0.473） out of 5（full mark）. Conclusion
SVF-gel fat grafting to ROOF layer combined with blepharoplasty is safe and effective in improving upper eyelid laxity and
depression in middle-aged and elderly women. SVF-gel has a good effect in the fine filling of the upper eyelid， and it can be
further developed with other surgical methods in the future.

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