SMAs Release And Suspension Through The Subeyebrow Incision Combined With Composite Tissue Mass Filling To Improve The Upper Eyelid Skin Relaxation And Depression

Objective:To explore the clinical effect of SMAS loosening suspension combined with compound tissue block filling through subbrow incision to improve upper eyelid skin laxity and upper eyelid depression.Methods:A retrospective analysis of 50 patients who were di agnosed as "flabby upper eyelid skin combined with sunken upper eyelid" in our hospital from January 2017 to January 2019 were retrospectively analyzed through subbrow incision SMAS relaxation suspension combined with dermal-subcutaneous Fat-muscle complex tissue flap filling: According to the patient’s upper eyelid skin slack,the skin area is designed to be removed,the skin is cut along the design line,and the skin,subcutaneous fat and orbicularis oculi muscle in the designed area are removed,the epid ermis is removed,and the dermis is formed-The subcutaneous fat-muscle composite tissue flap is freely transplanted and filled under the orbicularis oculi muscle in the depression area of the upper eyelid.The deep surface of the SMAS layer outside the incision was bluntly peeled down to the level of the lateral canthus,and the SMAS layer was lifted up and suspended on the deep orbital periosteum of the upper edge of the incision without significant tension.The subcutaneous and skin are sutured in laye rs and bandaged under pressure.C ollect the third-party grade evaluation data of skin sagging width and upper eyelid depression degree measured before operation,3 months after operation,and 6 months after operation,statistically with SPSS25.0 software,and analyze whether there are differences before and after the operation,and follow-up Recipient satisfaction and third-party evaluation of surgical results.Results:The width of skin sagging was compared before operation and 3 months after operation,a nd it was found that there were statistical significance in the three groups of mild,moderate and severe(T values were 25.85,45.65,26.83,and P values were all less than 0.0 01);The three groups were compared 3months after operation and 6 months a fter operation,and they were not statistically significant(T values were-1.78,-1.76,and-2.00,respectively,and P values were 0.83,0.83,0.81,respectively).In terms of the degree of upper eyelid depression,the chi-square test was performed on the preoperative and 3-month postoperative composition ratio,and there was a statistical difference(Chi-square value 8.994,P =0.01);the composition ratio was performed at 3 months postoperatively and 6 months postoperatively Chi-square test showed no s tatistical difference(P>0.05).The postoperative self-satisfaction rate of the patients was 96.0% at 3 months after operation,94.0%at 6 months after operation.Six months after the operation,the Strasser evaluation form was used to evaluate 50 patients,and it was found that they were basically bilaterally symmetrical,with good morphology and inconspicuous scars.Conclusion:The lateral SMAS release suspension lift and the dermal-subcutaneous fat-muscle compound tissue flap filling can effectively im prove upper eyelid skin laxity and upper eyelid depression.This operation has good effect,long maintenance time and few complications,and it is worthy of clinical application.