Observation On The Effect Of Orbicular Muscle Flap Combined With Autologous Fat Filling On The Upper Eyelid Depression

Objective To observe the effect and safety of orbicularis muscle flap combined with autologous fat filling in the correction of upper eyelid depression.Methods: Fifty-one patients with physiological upper eyelid depression admitted in our hospital from August 2016 to January 2018 were included as the research objects.All patients were treated in our hospital,and orbital muscle flaps were combined with autologous fat filling.All patients were female,aged 23-52 years,with an average age of(40.8 ± 2.7)years.The patients were followed up for 6-18 months,with an average time of 12 months.Analyze and evaluate the improvement of postoperative symptoms,repair effect,changes of anatomical indicators,survival rate of orbicular muscle flap and fat transplantation,postoperative complications and satisfaction.Results:A total of 51 patients with physiological upper eyelid depression treated in our hospital from August 2016 to January 2018 were included in this study.All patients were treated with orbicular muscle flap combined with autologous fat filling.All patients were female,aged 23-52 years,with an average age(40.8 ± 2.7)years of age and an average BMI(25.02 ± 3.24).Patients with orbital muscle flap combined with autologous fat filling improved the blepharoplasty and drooping symptoms to a certain extent.Among them,51 cases(100.00%)had significant improvement in depression repair,48 cases(94.12%)had good skin feeling in the orbital area,47cases(92.16%)had muscle function barriers in each functional area,and 41 cases(80.39)did not affect eye opening.%),43 cases(82.35%)did not affect closed eyes,44 cases(86.27%)did not affect eyes with large or small eyes,9 cases(90.00%)improved significantly in symptoms of bloating,and poor skin elasticity improved significantly There were 2 cases(50%),50 cases(98.04%)with significantly improved appearance,and 51 cases(100.00%)with significantly improved inferiority.The postoperative survey of the patient's surgical efficiency showed that 25 patients(49.10%)had significant treatment effects,24 patients(47.06%)had effective treatments,and 2 patients(3.92%)had ineffective treatments.The total effective rate was 96.08 %.The follow-up period was 1 to 12 months.Among the 51 patients,the total complication rate was 9.80%(5 patients),including 1 patient with asymmetric upper eyelid depression,1 patient with upper eyelid edema,and edema.There were 1patient and 2 patients with pain.After complications occurred,active treatment measures were taken,and the patients were cured after treatment.Forty-nine patients achieved good results;no serious adverse complications such as wound dehiscence,wound infection,local necrosis,local nodule formation,and ptosis were observed.After complications occurred,patients were actively treated with dressing changes and anti-infective measures,and all patients were cured after treatment.This surgical method has less bleeding,shorter operation time,less tissue removal,less obvious scars after incision,better appearance and morphology,and higher patient satisfaction(Table 5).The overall evaluation is that the probability of being very satisfied is24.10%,the probability of being basically satisfied is 69.00%,the probability of being dissatisfied is only 6.9%,and there are no patients who are very dissatisfied.Among them,the highest satisfaction rate was 19(65.52%)for improvement of symptoms,followed by an improvement in appearance(9.31.03%),and the satisfaction of scar condition was 1(3.45%).Patients were followed up before surgery,1 month after surgery,6 months after surgery,and 12 months after surgery.Patients' quality of life scores were recorded.The comparison results are shown in Table 7.Compared with preoperative,the subjective well-being,life satisfaction and self-worth of patients were significantly enhanced in 1 month,6 months and 12 months after operation,and the differences were statistically significant(P <0.05).The subjective well-being,life satisfaction,and self-worth of the patients at 6 months and 12 months after operation were stronger than those at 1 month after operation,and the differences were statistically significant(P <0.05).Compared with preoperative,the SAS and SDS scores of patients increased significantly at 1 month,6 months and 12 months after operation,and the differences were statistically significant(P <0.05).The SAS and SDS scores of patients at 6 months and 12 months after operation were higher than those at 1month after operation,and the difference was statistically significant(P <0.05).Conclusions:Orbicularis muscle flap combined with autologous fat filling for the treatment of upper eyelid depression,the upper eyelid depression is significantly improved after surgery,with significant effects and fewer complications.It is applicable to patients with mild to moderate severe upper eyelid depression.Patient satisfaction was higher after surgery.