J Cosmet Med 2021; 5(2): 57-66
Published online December 31, 2021
Zhi-Jun Wang, MD, PhD1 , Guanyi Li, MD1 , Shuzhong Guo, MD, PhD2 , DongQing Fu, MD3 , Bozhang Shen, MD3 , Chengxin Bai, MD1
1Institute of Facial Rejuvenation, Plastic Surgery Hospital of Xi’an International Medical Center, Xi’an, China
2Plastic Surgery Hospital Ear in Manufacturing Center, Xi’an International Medical Center, Xi’an, China
3Medical School of Yanbian University, Ji Ling, China
Correspondence to :
Zhi-Jun Wang
E-mail: 13998552625@163.com
© Korean Society of Korean Cosmetic Surgery & Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To explore the methods and safety of general abnormal anatomical layers and structure in rhytidectomy, which is also of clinical significance. In this group, 39 patients with static and dynamic deformities formed at different levels after liposuction and thread technique more than one time were treated with stable and active separation skills in high SMAS facelift operation. The results showed that the patients of this group could get the same effect of younger postoperative operation as “initial face” and solve dynamic adhesion deformity.
Methods: Magnetic resonance imaging and ultrasound were performed before operation, focusing on the abnormal changes of facial soft tissue. The results showed that the signal of the foreign body, the position and texture of scar, the relationship between scar and masseter fascia, buccal fat pad, and whether there was tissue defect or hyperplasia. In the operation, the normal separation was made in the second and fourth layers of the previously safe and easy to separate plane, instead of in the dense one or two layers of the scar. It is an alternative microsurgical separation technique. The key point is to separate the incomplete SMAS flap to achieve the expected good effect of rhytidectomy, release the scar adhesion and facial spasm. At the same time, the severed injury of facial nerve branches should be strictly prevented.
Results: 74 cases of facelift were taken in recent eight months and 67 patients were treated with micro plastic surgery. Among them, 39 patients received more than one facial liposuction and more than one thread lift. In the scar formed by liposuction and thread technology, liposuction is especially serious; liposuction can still absorb the structural layer, and scar directly involves the SMAS and buccal fat pad envelope containing facial nerve branches, one of which directly causes the injury of the mandibular marginal branch. Most of the chronic granuloma scar formed after the degradation of the thread technology is in the facial space, which causes the scar atresia of the space. The flap and SMAS flap of 39 cases were separated, most of which were facial nerve branches in scar. All of them were difficult to separate and form the SMAS flap of superficial temporal fascia-Orbicularis oculi-platysma, and 89.6% of the excellent facelift effect was obtained. Facial nerve injury was found in 2 cases, 1 case was right mandible marginal branch traction injury, and the other side was left corner nerve injury. In the process of recovery.
Conclusion: For patients with facial liposuction and thread technique, doctors must be prepared for the difficult separation of scar adhesion and have a high risk of facial nerve branch disconnection. If we don’t pursue the rejuvenation effect, it will lead to the existence of surgical effect discount, bilateral asymmetry, and dynamic adhesion deformity.
Keywords: aspiration lipectomy, cicatrix, facial nerve, rhytidoplasty, scar, sutures
J Cosmet Med 2021; 5(2): 57-66
Published online December 31, 2021 https://doi.org/10.25056/JCM.2021.5.2.57
Copyright © Korean Society of Korean Cosmetic Surgery & Medicine.
Zhi-Jun Wang, MD, PhD1 , Guanyi Li, MD1 , Shuzhong Guo, MD, PhD2 , DongQing Fu, MD3 , Bozhang Shen, MD3 , Chengxin Bai, MD1
1Institute of Facial Rejuvenation, Plastic Surgery Hospital of Xi’an International Medical Center, Xi’an, China
2Plastic Surgery Hospital Ear in Manufacturing Center, Xi’an International Medical Center, Xi’an, China
3Medical School of Yanbian University, Ji Ling, China
Correspondence to:Zhi-Jun Wang
E-mail: 13998552625@163.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To explore the methods and safety of general abnormal anatomical layers and structure in rhytidectomy, which is also of clinical significance. In this group, 39 patients with static and dynamic deformities formed at different levels after liposuction and thread technique more than one time were treated with stable and active separation skills in high SMAS facelift operation. The results showed that the patients of this group could get the same effect of younger postoperative operation as “initial face” and solve dynamic adhesion deformity.
Methods: Magnetic resonance imaging and ultrasound were performed before operation, focusing on the abnormal changes of facial soft tissue. The results showed that the signal of the foreign body, the position and texture of scar, the relationship between scar and masseter fascia, buccal fat pad, and whether there was tissue defect or hyperplasia. In the operation, the normal separation was made in the second and fourth layers of the previously safe and easy to separate plane, instead of in the dense one or two layers of the scar. It is an alternative microsurgical separation technique. The key point is to separate the incomplete SMAS flap to achieve the expected good effect of rhytidectomy, release the scar adhesion and facial spasm. At the same time, the severed injury of facial nerve branches should be strictly prevented.
Results: 74 cases of facelift were taken in recent eight months and 67 patients were treated with micro plastic surgery. Among them, 39 patients received more than one facial liposuction and more than one thread lift. In the scar formed by liposuction and thread technology, liposuction is especially serious; liposuction can still absorb the structural layer, and scar directly involves the SMAS and buccal fat pad envelope containing facial nerve branches, one of which directly causes the injury of the mandibular marginal branch. Most of the chronic granuloma scar formed after the degradation of the thread technology is in the facial space, which causes the scar atresia of the space. The flap and SMAS flap of 39 cases were separated, most of which were facial nerve branches in scar. All of them were difficult to separate and form the SMAS flap of superficial temporal fascia-Orbicularis oculi-platysma, and 89.6% of the excellent facelift effect was obtained. Facial nerve injury was found in 2 cases, 1 case was right mandible marginal branch traction injury, and the other side was left corner nerve injury. In the process of recovery.
Conclusion: For patients with facial liposuction and thread technique, doctors must be prepared for the difficult separation of scar adhesion and have a high risk of facial nerve branch disconnection. If we don’t pursue the rejuvenation effect, it will lead to the existence of surgical effect discount, bilateral asymmetry, and dynamic adhesion deformity.
Keywords: aspiration lipectomy, cicatrix, facial nerve, rhytidoplasty, scar, sutures
Kyoungjin Kang, MD, PhD, Sun Woo Lee, MS, Phoebe Kar Wai Lam, MBChB (Otago), MRCS (Edin), MScPDerm (Cardiff)
J Cosmet Med 2020; 4(2): 96-100 https://doi.org/10.25056/JCM.2020.4.2.96Ji Yun Choi, MD, PhD
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