基于上睑皮肤松垂机制的眉脂肪垫应用解剖学研究

doi:10.13418/j.issn.1001-165x.2022.6.04

Abstract

Abstract: Objective To provide anatomical basis for the replacement of eyebrow fat pad to improve the blepharoplasty of upper eyelid skin ptosis. Methods The eyebrow regions of 14 fresh frozen cadaver heads were dissected. The important adjacent relationship and anatomical parameters of eyebrow fat pad were recorded and measured. Results The eyebrow fat pad was located in the fascial fat layer between the frontalis muscle, the orbital part of the orbicularis oculi muscle and the periosteum, and it was closely connected with the orbicularis oculi muscle. While the connection between eyebrow fat pad and periosteum and orbital diaphragm was loose. The eyebrow fat pad gradually thinned upward to a fascia state, and moved downward into the fat layer under the orbicularis oculi muscle The medial side was the supra-trochlear neurovascular bundle, which continued outward with the fat layer of the superficial temporal fascia, showing a flat oval shape with a long transverse diameter. The mapping range on the body surface was located in the peak and tip of the eyebrow. The maximum thickness, vertical width, and horizontal length of eyebrow fat pad were (1.33±0.30) mm, (15.51±0.53) mm, (34.44±0.67) mm. Its main blood supply came from the branches of the supraorbital artery to the temporal side. The eyebrow fat pad formed a sliding space between the orbital septum and the muscle, which was conducive to eyebrow movement, but it would cause the lateral eyebrow to have insufficient support against gravity, resulting in the lateral orbital soft tissue sagging with the increasing of age. Conclusions The skin ptosis of the upper eyelid can be improved by replacing the eyebrow fat pad and fixing it on the periosteum of the orbital margin, which can not only adjust the position of the eyebrow, but also enhance the supporting structure of the soft tissue above the orbital margin, avoid the appearance of eyebrow ptosis, stabilize the surgical effect and improve the morphology of eyebrow and upper eyelid.

Key words: Anatomy; , , Eyebrow fat pad; , , Upper eyelid plastic surgery; , , Suspension fixation; , , Upper eyelid skin relaxation

CLC Number:

R322.91

Ma Kun, Li Pingsong, Hou Tuanjie, Chen Xiao, Ma Le, Rong Kunjie, Chen Jiaxiang . Applied anatomical study of eyebrow fat pad based on the mechanism of upper eyelid skin ptosis [J]. Chinese Journal of Clinical Anatomy, 2022, 40(6): 649-654.

References 24

[1]	Asaad M, Kelarji AB, Jawhar CS, et al. Eyebrow height changes with aging: a systematic review and meta-analysis[J]. Plast Reconstr Surg Glob Open, 2019, 7(9): e2433. DOI:10.1097/GOX.0000000000002433.
[2]	Vrcek I, Chou E, Somogyi M, et al. Volumization of the brow at the time of blepharoplasty: treating the eyebrow fat pad as an independent unit[J]. Ophthalmic Plast Reconstr Surg, 2018, 34(3):209-212. DOI:10.1097/IOP.0000000000000911.
[3]	Tzikas TL. Fat grafting volume restoration to the brow and temporal regions[J]. Facial Plast Surg, 2018, 34(2): 164-172. DOI:10.1055/s-0038-1636922.
[4]	Lee S, Yen MT. Nonsurgical rejuvenation of the eyelids with hyaluronic acid gel injections[J]. Semin Plast Surg, 2017, 31(1): 17-21. DOI:10.1055/s-0037-1598189.
[5]	Varga R. Providing optimal rejuvenation to the periocular area using botulinum toxin a neuromodulators and hyaluronic acid dermal fillers[J]. Plast Surg Nurs,2019, 39(4): 119-124. DOI:10.1097/PSN. 000000 0000000279.
[6]	Blandford AD, Bachour SP, Chen R, et al. Dimensions and morphologic variability of the retro-orbicularis oculi and frontalis muscle fat pad[J]. Ophthalmic Plast Reconst Surg, 2019, 35(5): 447-450. DOI:10.1097/IOP.0000000000001314.
[7]	Wang X, Wang H. Anatomical study and clinical observation of retro-orbicularis oculi fat (ROOF)[J]. Aesthetic Plast Surg, 2020, 44(1): 89-92. DOI:10.1007/s00266-019-01530-2.
[8]	Lemke BN, Stasior OG. The anatomy of eyebrow ptosis[J]. Arch Ophthalmol,1982,100(6):981-986. DOI:10.1001/archopht. 1982. 01030 030989019.
[9]	Jordan DR. The brow fat pad[J]. Plast Reconstr Surg, 1991, 88(1): 177-178. DOI:10.1097/00006534-199107000-00052.
[10]	May JW Jr, Fearon J, Zingarelli P. Retro-orbicularis oculus fat (ROOF) resection in aesthetic blepharoplasty: a 6-year study in 63 patients[J]. Plast Reconstr Surg, 1990, 86(4): 682-689. DOI:10.1097/00006534-199010000-00011.
[11]	Zhang YS, Zhou Q, Zhang J, et al. Local retro-orbicularis oculus fat (ROOF) resection in upper blepharoplasty: A retrospective evaluation study of 65 bilateral upper blepharoplasties[J]. J Plast Reconstr Aesthet Surg, 2019, 72(8): 1373-1378. DOI:10.1016/j.bjps.2019.04.010.
[12]	Osaki MH, Osaki TH, Osaki T. Infrabrow skin excision associated with upper blepharoplasty to address significant dermatochalasis with lateral hooding in select asian patients[J]. Ophthalmic Plast Reconstr Surg, 2017, 33(1):53-56. DOI:10.1097/IOP.0000000000000644.
[13]	Knize DM. An anatomically based study of the mechanism of eyebrow ptosis[J]. Plast Reconstr Surg, 1996, 97(7): 1321-1333. DOI:10.1097/00006534-199606000-00001.
[14]	侯文明, 卢乐平, 郭秀莲, 等. 眉脂肪垫瓣的解剖学基础研究[J]. 中国临床解剖学杂志, 2005, 23(5): 477-480. DOI:10.3969/j.issn.1001-165X.2005.05.008.
[15]	Eftekhari K, Peng GL, Landsberger H, et al. The brow fat pad suspension suture: safety profile and clinical observations[J]. Ophthalmic Plastic Reconstr Surg, 2018, 34(1):7-12. DOI:10.1097/IOP. 0000000000000831.
[16]	斯楼斌，张明子，孔晓，等.人体眶周脂肪注射的应用解剖[J]. 中华整形外科杂志，2019，35（11）：1114-1119. DOI： 10.3760/cma.j.issn.1009-4598.2019.11.011.
[17]	Swift A, Liew S, Weinkle S, et al. The facial aging process from the "inside out"[J]. Aesthet Surg J, 2021, 41(10): 1107-1119. DOI:10.1093/asj/sjaa339.
[18]	Richards HS, Jenkinson E, White P, et al. Patient reported psychosocial functioning following successful ptosis surgery[J]. Eye (Lond), 2022,36(8):1651-1655. DOI:10.1038/s41433-021-01685-w.
[19]	Zhou X, Zeng N, Wang H. Correction of upper-eyelid depression through retro-orbicularis oculi fat (ROOF) augmentation using periumbilical adipose graft[J]. Aesthetic Plast Surg, 2020, 44(6): 2131-2136. DOI:10.1007/s00266-020-01828-6.
[20]	Kashkouli MB, Abdolalizadeh P, Abolfathzadeh N, et al. Corrigendum to "periorbital facial rejuvenation; applied anatomy and pre-operative assessment" [J]. J Curr Ophthalmol, 2018, 30(2): 188-189. DOI:10.1016/j.joco.2017.11.013.
[21]	马坤, 李平松, 胡再昌, 等. 单点内折固定眼轮匝肌恢复眼周年轻化[J]. 中华整形外科杂志, 2020, 36(12): 1315-1323. DOI:10.3760/cma.j.cn114453-20200702-00400.
[22]	Silva AMBRD, Magri LV, Osborne PR, et al. Three-dimensional nasal alterations in Le Fort I advancement: linear measurements, angles, nasal indices, and volume differences[J]. J Craniofac Surg, 2019,30(4):1125-1130. DOI:10.1097/SCS.0000000000005103.
[23]	马庆云, 段风, 李会斌. 基于MRI三维重建的成年人颅面部软组织测量分析[J]. 解剖学研究, 2021,43(2):155-1593. DOI: 10.3969/j.issn.1671-0770.2021.02.013.
[24]	王长青,杨荣丽,付升旗. 前交叉韧带损伤重建术后及随访的弥散张量成像观测[J]. 中国临床解剖学杂志,2021,39（5）:552-556. DOI: 10.13418/j.issn.1001-165x.2021.05.01.

Applied anatomical study of eyebrow fat pad based on the mechanism of upper eyelid skin ptosis

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