Abstract：
BACKGROUND: Incisional double-eyelid blepharoplasty is the main surgical technique to obtain an artificial crease. Postoperative complications decrease patients\' satisfaction, and patients with prominent depressed groove and persistent pretarsal swelling (sausage phenomenon) usually need revision surgery. To resolve the sausage phenomenon after blepharoplasty, we adopt Outer Fascia of Orbicularis Oculi Muscle (OFOOM)-Orbicularis (OOM)-Aponeurosis Fixation Approach to create natural double eyelids.
METHODS: We included 68 patients in the study. The inclusion criteria for revision surgery were as follows: (1) pretarsal OOM remained after primary surgery, (2) prominent depressed surgical scar/groove and persistent pretarsal bulge (sausage phenomenon), (3) postsurgical abnormally wide crease. The surgical procedure involved releasing the pretarsal OOM, forming OFOOM-OOM flap, and OFOOM-OOM flap fixed with aponeurosis. Outcome observations were assessed using the FACE-Q questionnaire, and the follow-up period ranged from 6 to 36 months (mean=18 months).
RESULTS: The depressed groove and pretarsal bulge showed significant improvements, and FACE-Q scores of the 68 patients before surgery (mean scores=66) compared with those after surgery (mean scores=90) were significantly different (P<0.01). Four patients with palpebral fold asymmetry and two patients with shallow eyelids received revision surgery, and patients were satisfied with the secondary surgery effects. Six patients presented with unnatural curves of folds and revision surgery alleviated these situations.
CONCLUSIONS: Outer Fascia of Orbicularis Oculi Muscle (OFOOM)-Orbicularis (OOM)-Aponeurosis Fixation Approach is an effective way to resolve the sausage phenomenon. The OFOOM-OOM flap is a reliable and flexible structure to create natural double eyelids.
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: We included 68 patients in the study. The inclusion criteria for revision surgery were as follows: (1) pretarsal OOM remained after primary surgery, (2) prominent depressed surgical scar/groove and persistent pretarsal bulge (sausage phenomenon), (3) postsurgical abnormally wide crease. The surgical procedure involved releasing the pretarsal OOM, forming OFOOM-OOM flap, and OFOOM-OOM flap fixed with aponeurosis. Outcome observations were assessed using the FACE-Q questionnaire, and the follow-up period ranged from 6 to 36 months (mean=18 months).
RESULTS: The depressed groove and pretarsal bulge showed significant improvements, and FACE-Q scores of the 68 patients before surgery (mean scores=66) compared with those after surgery (mean scores=90) were significantly different (P<0.01). Four patients with palpebral fold asymmetry and two patients with shallow eyelids received revision surgery, and patients were satisfied with the secondary surgery effects. Six patients presented with unnatural curves of folds and revision surgery alleviated these situations.
CONCLUSIONS: Outer Fascia of Orbicularis Oculi Muscle (OFOOM)-Orbicularis (OOM)-Aponeurosis Fixation Approach is an effective way to resolve the sausage phenomenon. The OFOOM-OOM flap is a reliable and flexible structure to create natural double eyelids.
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：
背景：切口重睑成形术是获得人工折痕的主要手术技术。术后并发症降低患者满意度，并且患有突出的凹陷沟和持续的关节前肿胀（香肠现象）的患者通常需要进行翻修手术。为了解决眼睑成形术后的香肠现象，我们采用眼轮匝肌外筋膜（OFOOM）-眼轮匝肌（OOM）-筋膜固定方法来创建自然的双眼皮。
方法：我们纳入了68例患者。修正手术的纳入标准如下：（1）初次手术后仍保留骨前OOM，（2）突出的凹陷的手术疤痕/沟和持续的甲状隆起（香肠现象），(3)术后异常宽折痕。手术过程包括释放足前OOM，形成OFOOM-OOM瓣，和OFOOM-OOM皮瓣固定与肌腱膜。使用FACE-Q问卷评估结果观察结果，随访时间6~36个月(平均18个月)。
结果：凹陷的凹槽和足前隆起显示出明显的改善，68例患者术前FACE-Q评分(平均得分为66分)与术后FACE-Q评分(平均得分为90分)比较差异有统计学意义(P<0.01)。4例睑皱不对称患者和2例眼睑浅的患者接受了翻修手术，患者对二次手术效果满意。六名患者表现出不自然的褶皱曲线和翻修手术缓解了这些情况。
结论：眼轮匝肌外筋膜（OFOOM）-眼轮匝肌膜固定方法是解决香肠现象的有效方法。OFOOM-OOM皮瓣是一个可靠和灵活的结构，创造自然的双眼皮。
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：我们纳入了68例患者。修正手术的纳入标准如下：（1）初次手术后仍保留骨前OOM，（2）突出的凹陷的手术疤痕/沟和持续的甲状隆起（香肠现象），(3)术后异常宽折痕。手术过程包括释放足前OOM，形成OFOOM-OOM瓣，和OFOOM-OOM皮瓣固定与肌腱膜。使用FACE-Q问卷评估结果观察结果，随访时间6~36个月(平均18个月)。
结果：凹陷的凹槽和足前隆起显示出明显的改善，68例患者术前FACE-Q评分(平均得分为66分)与术后FACE-Q评分(平均得分为90分)比较差异有统计学意义(P<0.01)。4例睑皱不对称患者和2例眼睑浅的患者接受了翻修手术，患者对二次手术效果满意。六名患者表现出不自然的褶皱曲线和翻修手术缓解了这些情况。
结论：眼轮匝肌外筋膜（OFOOM）-眼轮匝肌膜固定方法是解决香肠现象的有效方法。OFOOM-OOM皮瓣是一个可靠和灵活的结构，创造自然的双眼皮。
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.
