Abstract：
OBJECTIVE: To explore the clinical application of orbital fat fascia flap in the correction of sunken upper eyelid in Asian blepharoplasty based on anatomical and histological research.
METHODS: Observe the histological structure of the orbital fat and its fascia vascularity through cadaver anatomy and histological sections of 10 cadavers. Based on the anatomical and histological characteristics of orbital fat, 36 patients with mild to moderate sunken upper eyelids were corrected by transposition of orbital fat fascia flap with preservation of fascia vascular pedicle. During the operation, the lateral part of the central cellulite of orbital fat was separated longitudinally and transferred to the sunken place to correct the sunken upper eyelid.
RESULTS: Anatomy and histology show that the orbital fat was located between the anterior layer of the levator aponeurosis and the posterior layer of the orbital septum and was separated into fat lobules by many fibrous septa. The blood vessels move forward from back to front along the orbital fat interlobular septum, and the blood vessels in the capsule below the orbital fat are abundant. Clinical results showed that the shape of the sunken upper eyelid was significantly improved in 35 cases after correction with this method during the postoperative follow-up from 9 months to 18 months. The mean sunken depth improved from 6.2mm (±1.0 mm) preoperatively to 2.2mm (±0.9 mm) at the last follow-up with a statistical significance. And only 1 case had partial depression in the unilateral eyelid and received autologous granular fat transplantation with satisfactory postoperative results.
CONCLUSIONS: The transposition of orbital fat fascia flap with longitudinal separation and preservation of fascia vascular pedicle can better correct the sunken upper eyelid during blepharoplasty, and the long-term effect is stable, which is worthy of clinical promotion.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
METHODS: Observe the histological structure of the orbital fat and its fascia vascularity through cadaver anatomy and histological sections of 10 cadavers. Based on the anatomical and histological characteristics of orbital fat, 36 patients with mild to moderate sunken upper eyelids were corrected by transposition of orbital fat fascia flap with preservation of fascia vascular pedicle. During the operation, the lateral part of the central cellulite of orbital fat was separated longitudinally and transferred to the sunken place to correct the sunken upper eyelid.
RESULTS: Anatomy and histology show that the orbital fat was located between the anterior layer of the levator aponeurosis and the posterior layer of the orbital septum and was separated into fat lobules by many fibrous septa. The blood vessels move forward from back to front along the orbital fat interlobular septum, and the blood vessels in the capsule below the orbital fat are abundant. Clinical results showed that the shape of the sunken upper eyelid was significantly improved in 35 cases after correction with this method during the postoperative follow-up from 9 months to 18 months. The mean sunken depth improved from 6.2mm (±1.0 mm) preoperatively to 2.2mm (±0.9 mm) at the last follow-up with a statistical significance. And only 1 case had partial depression in the unilateral eyelid and received autologous granular fat transplantation with satisfactory postoperative results.
CONCLUSIONS: The transposition of orbital fat fascia flap with longitudinal separation and preservation of fascia vascular pedicle can better correct the sunken upper eyelid during blepharoplasty, and the long-term effect is stable, which is worthy of clinical promotion.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
摘要：
目的：在解剖学和组织学研究的基础上，探讨眼眶脂肪筋膜瓣在亚洲眼睑成形术中矫正上眼睑凹陷的临床应用。
方法：通过尸体解剖和10具尸体的组织学切片观察眼眶脂肪及其筋膜血管的组织学结构。根据眼眶脂肪的解剖和组织学特点，采用保留筋膜血管蒂的眶脂肪筋膜瓣移位术矫正轻中度上眼睑凹陷36例。在操作过程中,眼眶脂肪中央脂肪团的外侧部分纵向分离，转移到凹陷的地方，以纠正凹陷的上眼睑。
结果：解剖和组织学显示，眶脂肪位于提上睑膜的前层和眶隔的后层之间，并被许多纤维间隔分离成脂肪小叶。血管沿着眶脂肪小叶间隔由后向前移动，眼眶脂肪下的囊内血管丰富。临床结果表明，在术后9个月至18个月的随访中，有35例采用该方法矫正后的上眼睑凹陷形状明显改善。平均凹陷深度从术前6.2mm(±1.0mm)改善至末次随访时的2.2mm(±0.9mm),差异有统计学意义。仅1例单侧眼睑部分凹陷，行自体颗粒脂肪移植，术后效果满意。
结论：眼眶脂肪筋膜瓣的纵向分离和保留筋膜血管蒂的转位能较好地纠正眼睑成形术中的上眼睑凹陷。长期效果稳定，值得临床推广。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
方法：通过尸体解剖和10具尸体的组织学切片观察眼眶脂肪及其筋膜血管的组织学结构。根据眼眶脂肪的解剖和组织学特点，采用保留筋膜血管蒂的眶脂肪筋膜瓣移位术矫正轻中度上眼睑凹陷36例。在操作过程中,眼眶脂肪中央脂肪团的外侧部分纵向分离，转移到凹陷的地方，以纠正凹陷的上眼睑。
结果：解剖和组织学显示，眶脂肪位于提上睑膜的前层和眶隔的后层之间，并被许多纤维间隔分离成脂肪小叶。血管沿着眶脂肪小叶间隔由后向前移动，眼眶脂肪下的囊内血管丰富。临床结果表明，在术后9个月至18个月的随访中，有35例采用该方法矫正后的上眼睑凹陷形状明显改善。平均凹陷深度从术前6.2mm(±1.0mm)改善至末次随访时的2.2mm(±0.9mm),差异有统计学意义。仅1例单侧眼睑部分凹陷，行自体颗粒脂肪移植，术后效果满意。
结论：眼眶脂肪筋膜瓣的纵向分离和保留筋膜血管蒂的转位能较好地纠正眼睑成形术中的上眼睑凹陷。长期效果稳定，值得临床推广。
方法：本期刊要求作者为每篇文章分配一定程度的证据。对于这些循证医学评级的完整描述，请参阅目录或在线作者说明www。springer.com/00266.
