目的 总结并探讨高位SMAS除皱术的操作要点.方法 采用经典的除皱术切口,皮下分离完成后,确保在颞中筋膜浅面分离颞浅筋膜-SMAS,避免颞支损伤.在颧弓颧突表面,以钝、锐性相结合的分离技术离断颧弓韧带,释放颞部、颧部、下面部、颈部以及面中部外1/3甚或1/2的SMAS瓣.结果 共46例患者行高位(超高位)SMAS除皱术,40例随访12个月以上,效果优20例,良好18例,一般2例,优良率95％.结论 高位SMAS除皱术可获得较好的面部年轻化效果,其关键在于颞浅筋膜的安全分离和颧弓韧带的充分离断.%Objective To summarize the key points of high SMAS facelift. Methods Forty-six patients who had received high SMAS facelift were included in this study. All the patients had subcutaneous dissection by classic facelift incision. The temporal region dissection was performed superficial to middle temporal fascia to avoid temporal branches injury. The zygomatic ligaments were released by sharp and blunt dissection at malar prominence and zygomatic arch. After sub-SMAS dissection, a complete SMAS-platysma flap was raised including temporal, malar, lower face, neck, and one third or half of the midface. Results Forty patients had postoprative follow-up for more than one year. Twenty patients showed" excellent" results, eighteen patients had " good" results , two patients " common" . The good and excellent rate was 95％ . Conclusions The key points of high SMAS facelift to achieve ideal outcome depend on the safe dissection of superficial temporal fascia and the release of zygomatic ligaments.
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