Contained dissection on the immobile zone of SMAS for facial rhytidectomy
10.3760/cma.j.cn114453-20200204-00026
- VernacularTitle:SMAS瓣"不动区"的有限性剥离在除皱术中的应用
- Author:
Lehao WU
1
;
Chang ZHANG
;
Wuyan LI
;
Tailing WANG
;
Jiaqi WANG
Author Information
1. 中国医学科学院北京协和医学院整形外科医院面颈整形美容中心 100144
- Keywords:
Superficial musculoaponeurotic system;
Face;
Anatomy;
Suspension
- From:
Chinese Journal of Plastic Surgery
2021;37(2):198-204
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce the clinical experiences in multilevel suspension rhytidectomy with limited dissection of the immobile zone in superficial musculoaponeurotic system(SMAS).Methods:From January 2014 to December 2019, at total of 110(1 male and 109 females, 46-72 years old)cases of facial rhytidectomy were performed in our institution. During the operation, the area of skin flap elevation is similar to the classic rhytidectomy. SMAS layer dissection is contained within the immobile area.Dynamic evaluation was conducted every 1 cm of SMAS flap elevation, by gently pulling the SMAS flap.The change of depth of the nasolabial fold, the change of lips elevation were the parameters for which the degree of dissection is determined.The subjective satisfaction and overall improvement were investigated and the complications were recorded.Results:All 110 patients were followed up for 6-30 months, with an average of 12 months. The subjective satisfaction rate was 94.5%(104/110). Among them , 61 cases rated "very satisfied" , 43 cases were "satisfied" , 2 cases were "acceptable" and 4 cases were "unsatisfactory" . All patients had significant improvement on brow sagging, nasolabial fold, mouth sagging, and skin texture. The early postoperative complications were local hematoma in 4 cases (3.6%). The long-term complications included 3 cases (2.7%) of periauricular scar hyperplasia , 2 cases (1.8%) of earlobe displacement and 1 case (0.9%) of hair loss at temporal incision (0.9%).Conclusions:Limited dissection of the immobile zone in SMAS flap has no significantly negative impact on the overal outcomes. By such contained surgical dissection, facial rejuvenation can be achieved, and the risks of complications were reduced.
