| Objective: Anatomical basis of the eyebrow area frontal muscle fascia-subcutaneous fat flap has been studied. Eyebrow area morphological observation onpatients of senile upper eyelid sag has been conducted to research the clinicalapplication value of the eyebrow area frontal muscle fascia-subcutaneous fat flap, andthe morphological commonalities and differences of this patient population. It is a basisfor clinical preoperative diagnosis and a theoretical guidance for clinical operation.Method： Morphological observation on70female patients aged from35to60with sagging upper eyelid featured skin aging around eyes such as2/3sag outsideeyebrow, upper eyelid skin flabby, senile upper eyelid sag etc. was performed.Proportional relation between upper eyelid height and palpebral fissure height ofpatients with senile upper eyelid sag was measured using individual palpebral fissureheight as basic unit and methods of computer aided image, fix image point with Image-pro plus.The range, thickness and tightness of fat under eyebrow skin,the SMASjunction structural characteristic and level position of eyebrow area frontal muscle,orbicularis oculi muscle and superficial muscles were observed on two adult corpseheads. Completed microscopical observation on105pieces P45eye around biologyplastination slices and performed accurate measurement with Auto-CAD2007on thethickness and the peelable length and width of fat flap under frontal musclefascia.Observation of clinical surgery of eyebrow lift surgery (Eyebrow excision) on24cases has been conducted, all are female aged from35to60, observed the range,thickness and density of the eyebrow subcutaneous fat layer, the Interweave area musclecontorts of the frontal muscle and orbicularis oculi, measured the thickness of frontalmuscle fascia-subcutaneous fat and studied its feasibility on clinical treatment of senile upper eyelid sag.Result: Wider eyebrow/eye spacing (larger than the average value of1.08±0.21)is one of the main factors that cause the sunken upper eyelid with a risk of upper eyelidsag on patients of Wider eyebrow/eye spacing of24.6times than that of narroweyebrow/eye spacing. The layers of frontal muscle fascia are located below the skin andsubcutaneous fat layer and above brow fat pad. Their level actually is SMAS fascia(Weaving area of the orbicularis oculi muscle and frontalis muscle aponeurosis).The average length of the frontal muscle fascia flap stripping down can be up to (7.87±0.13) mm. The average width of the frontalis aponeurosis flap on vertical line over orbitis (48.34±0.22) mm, The average thickness of the frontalis aponeurosis flap is (2.18±0.07) mm. Eyebrow frontal muscle fascia-subcutaneous fat flap can be designed into4.5cm x0.9CM size and turned over downward or retracted naturally to the place beloworbit which can cover the whole sag. The fascia flap pedicle connected with orbicularisoculi muscle which supply blood for it and has very high survival rate.Conclusion: Frontal muscle fascia-subcutaneous fat flap transplantation ofeyebrow area is an effective operation method for senile upper eyelid sag of light andmoderate content. It has the following advantages:1、Frontalis muscle fascial flap of supply area will not be completely cut off. Thefunctions of all the muscles will be normal.Tissues of transfer and fill will have agood blood supply.2、The donor and recipient zone are adjacent that convenient to transfer.3、The incision is concealed and the scar is not obvious after surgery.4、Operation is simple and convenient and during which eyebrow lift surgery(Eyebrow excision) and other operation can be conducted. |
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