【整容真相之一】雙眼皮手術究竟能將你變多美？請看整形外科最權威期刊PRS中的學術案例

02-08

「眼睛是心靈的窗口」，這句話很爛俗，但是其道理無可置疑。眼部在面部審美的核心，眼睛美不美對面部整體美觀度來說無比重要。眼部對審美的重要性，即使是沒經過任何審美教育的人也能感受到，也正是因為眼部審美的重要性，所以眼部手術（重瞼術）也是亞洲人做得最多的美容外科手術（歐美人種都是天生的雙眼皮）。

雙眼皮手術如此流行，以至於其廣告自然也鋪天蓋地。如果你也有意向做雙眼皮手術，你很容易在網路上檢索到無數做了雙眼皮然後整個人直接不一樣的案例。這些妖艷的案例是不是很刺激你？當然，你也可能很理性，明白那不過是「照騙」而已，但是雙眼皮手術（以及其它眼部手術）效果究竟怎麼樣呢？你也不知道。我們放出我院的案例，你也會一樣的懷疑，但是對我們來說，求美者建立合理的預期非常重要。所以思來想去，我們決定先引用一些整形外科最權威雜誌Plastic and Reconstructive Surgery（《整形與重建外科》，業界常簡稱為PRS，以下將使用簡稱）中公開發表的學術案例，以幫助你了解清楚眼部手術的理想效果是怎樣的。

埋線重瞼術學術案例

Case 1. (Above) Preoperative view ofthe Asian single eyelid. (Below) Three-year postoperative view after the double-eyelid operation.

案例 1.(上圖)典型亞洲單眼皮術前情況。(下圖) 雙眼皮手術三年後的情況。

Case 2. (Above) Left single eyelid appearance in a patient obtained preoperatively. (Below) One-year postoperative view after the double-eyelid operation.

案例 2.(上圖)一位患者左側單眼皮的術前形態。(下圖)雙眼皮手術一年後的情況。

（案例1-2均引用自PRS論文《A Transcutaneous, Subcutaneous, and Intratarsal Suturing Procedurein Double Eyelid Surgery》）

埋線+切開法重瞼術學術案例

Case 3. Photographs of a 23-year-old woman with a single-eyelid (above) preoperatively and (below) 20 months postoperatively.

案例 3.(上圖)一位23歲單眼皮女性的術前情況和(下圖)雙眼皮手術20個月後的情況。

Case 4. Photographs of a 26-year-old woman with single-eyelid and mildptosis (above) preoperatively and (below) 6 months postoperatively.

案例 4.(上圖)26歲單眼皮女性並伴有輕度上瞼下垂的術前情況和(下圖)手術6個月後的情況。

Case 5. Photographs of a 25-year-old woman with ptosis and asymmetry of the double-eyelid by suture technique (above) preoperatively and (below) 17 months postoperatively, with simultaneous correction of ptosis and asymmetry of the double-eyelid.

案例 5.(上圖)一個25歲女性伴有上瞼下垂以及重瞼術後雙眼皮不對稱的術前情況，(下圖)上瞼下垂矯正和重瞼術不對稱矯正手術17個月後的情況。

Case 6. Photographs of a 50-year-old woman with single-eyelid and moderate ptosis (above) preoperatively and (below) 3 months postoperatively, with simultaneous skin excision of the upper eyelid and elevation of the eyebrow using endoscopic surgery.

案例 6.50歲單眼皮女性伴有中度上瞼下垂的術前情況(上圖)，(下圖)採用內窺鏡進行上瞼皮膚切除和眉毛抬高手術後3個月的情況。

（案例3-6均引用自PRS論文《New Technique Combined with Suture and Incision Method for Creating a More Physiologically Natural Double-Eyelid》）

切開去脂重瞼術學術案例

Case 7. Grade1: (Above) Preoperative view. (Below) Postoperative view.

案例 7. (上圖)術前照片。(下圖)術後照片。

Case 8. (Above) Preoperative view. (Center) Intraoperative view with tissues removed. PIT, peri-incisional tissue; OF,orbital fat; PT,pretarsal tissue. (Below) Postoperative view.

案例 8.(上圖)術前照片。(中圖)組織移除後的術中情況。PIT,手術切口組織；OF,眶脂肪；PT,瞼板前組織。(下圖)術後照片。

Case 9. A grade 4 patient without severe epicanthus. (Above) Preoperative view. (Center) Intraoperative view with tissue removed. (Below) Postoperative view.

案例 9.沒有嚴重內眥贅皮的患者。(上圖)術前照片。(中圖)組織移除後的術中照片。 (下圖)術後照片。

Case 10. A grade 4 patient with severe epicanthus. (Above) Preoperative view. (Center) Intraoperative view with tissues removed. A half Z-plasty was used to alleviate epicanthus. (Below) Postoperative view. RMF, upper retromuscular fatty tissue; OF, orbital fat; PIT, peri-incisional tissue; PT, pretarsal tissue.

案例 10.有嚴重內眥贅皮的患者。(上圖)術前照。(中圖)組織移除後的術中照。用半Z成形術用來減輕內眥贅皮成形。(下圖)術後照。RMF，上部脂肪組織；OF，眶脂肪； PIT，切口四周組織；PT，瞼板前組織。

（案例7-10均引用自PRS論文《Systematic Approach and Selective Tissue Removal in Blepharoplasty for Young Asians》）

內眥贅皮矯正術學術案例

Case 11. Rearrangement of orbicularis oculi muscle. When doing the repositioning the muscle, we just pushed the detached muscle fibers upward without fixation. Because the muscle is retracted upward well after releasing and repositioning procedure, we can get the effect of reducing the tension and volume of hypertrophied muscle.

案例 11.眼輪匝肌重排布。當做肌肉重新定位時，我們只需將固定的肌肉纖維向上推移而無需固定。因為在釋放和重新定位的過程後，肌肉收縮向上狀況良好，我們可以減少有張力和較厚的肌肉體積的影響。

Case 12. Intraoperative view. Above, The right eye shows the status after finishing the cutting of dense fibrous tissue and rearrangement of orbicularis oculi muscle above the medial canthal tendon. In comparison with the left side, the abnormal tension with contracture in the epicanthal fold is eliminated immediately by this procedure alone. Middle, After suturing between points A and C. Below, After suturing of skin incision. There is significant improvement of contracted epicanthal fold compared with preoperative status.

案例 12.術中觀察情況。上圖，右眼顯示完成緻密纖維組織和眼輪匝肌的內眥腱重排切割後的狀態。對比左眼情況，內眥贅皮攣縮張力異常在手術過程中是立即消除的。中圖，在A和C之間的縫合點。下圖，在縫合皮膚切口後，對比術前狀況，內眥贅皮的情況有明顯改善。

Case 13. A 25-year-old woman with relapsed epicanthal fold and scar on medial canthal area after the first epicanthoplasty. She received prior epicanthoplasty 3 years ago. Above, Before the surgery. Below, 1 year after the surgery. The relapsed epicanthal fold and the scar were successfully removed.

案例13.一個25歲的女性在第一次內眥贅皮矯正術後，出現複發性內眥贅皮以及內眥區瘢痕。她在3年前進行了內眥贅皮矯正手術。上圖是手術前的情況。下圖是手術後1年的情況。複發性內眥贅皮和瘢痕均成功移除。

Case 14. A 22-year-old woman with relapsed epicanthal fold and scar on medial canthal area after the first epicanthoplasty. She received prior epicanthoplasty 2 years ago. Above, Before the surgery. Below, 6 months after the surgery. The relapsed epicanthal fold and the scar were successfully removed.

案例 14.一個22歲的女性在第一次內眥贅皮矯正手術後，存在複發性內眥贅皮和瘢痕內眥區。她在2年前進行了內眥贅皮矯正手術。上圖是手術前情況。下圖是手術後6個月的情況。複發性內眥贅皮和瘢痕均成功移除。

（案例11-14均引用自AESTHETIC SURGERY論文《Corrective Epicanthoplasty in Patients With Unnatural Results of Prior Epicanthoplasty》）

多層重瞼矯正術學術案例

Case 15. (Above) A 17-year-old patient presented with the triple fold on the left eye and ptosis both eyes.She had undergone surgery for ptosis at another hospital 7 days previously, and the triple fold line developed without the correction of ptosis. Together with bilateral ptosis surgery, corrective surgery for the triple fold line of the left eye was performed. During surgery,the adhesion area was sought and released,the septum and fat were pulled down and fixated,and the superior orbicularis oculi muscle was pulled down and fixated. (Below) One-month postoperative view shows resolution of the left triple fold line.

案例 15.(上圖)一個17歲的病人出現的眼皮三折線以及上瞼下垂的情況。她7天前在醫院接受了不正確的上瞼下垂手術治療後，出現眼皮三折線。雙側上瞼下垂手術是伴隨著左眼三折線矯正手術一起進行的。在手術過程中，隔膜和脂肪被拉下，眼輪匝肌被拉下和固定。(下圖)術後1個月的情況.

Case 16. (Above) A 36-year-old patient presented with the triple fold bilaterally.She had undergone double-eyelid surgery 10 years previously. Eyelid surgery caused her to have the high fold. After that, she underwent secondary eyelid surgery for correction of the high fold but developed the triple fold line. Thus, revision eyelid surgery was again performed that included fat grafting. The triple fold line remained.During surgery, the adhesion area was sought and released, the septum and orbital fat were pulled down and fixated, and the superior orbicularis oculi muscle was pulled down and fixated. After skin suture, taping was performed at the site of the original triple fold line for temporary fixation by creating a skin roll. (Below) Two-week postoperative view shows resolution of the bilateral triple fold lines.

案例 16.(上圖)一位36歲的病人雙側眼皮都出現了三次摺疊，她曾在十年前接受了雙眼皮手術。這個手術讓她出現了眼皮摺疊的情況。之後，她進行了二次眼瞼手術矯正，但發展了眼皮三折線。因此，再次進行眼瞼矯正手術，包括脂肪移植。三折線仍然存在。在手術過程中，隔膜和眶脂肪被拉下及固定，眼輪匝肌被拉下固定。縫合皮膚後，通過創建一個皮膚捲曲對三折線處進行暫時固定。(下圖)眼皮三者險矯正手術後2周的情況。

（案例15-16均引用自PRS論文《Surgical Correction of Multiple Upper Eyelid Folds in East Asians》）

上瞼下垂矯正術學術案例

Case 17. A 23-year-old male patient underwent blepharoptosis correction with the levator aponeurosis–Müller muscle complex advancement with three partial incisions. (Above) The preoperative margin re?ex distance 1 was 0.1 mm for the right eye and 0.3 mm for the left eye. (Below) Photograph obtained 7 months postoperatively. The postoperative margin re?ex distance 1 measured 3.4 mm for both eyes.

案例 17. 一個23歲的男性患者進行上瞼下垂矯正與上瞼提肌腱膜–通過三部分切口進行的穆勒肌複雜手術。(上圖) 術前，邊緣反射距離是右眼0.1毫米以及左眼0.3毫米. (下圖) 照片顯示術後7個月，雙眼的邊緣反射距離都是3.4毫米。

Case 18. A 26-year-old female patient underwent blepharoptosis correction with the levator aponeurosis–Müller muscle complex advancement with three partial incisions. (Above) The preoperative margin ref ex distance 1 measured 0.5 mm for the right eye and 0.8 mm for the left eye. (Below) Photograph obtained 8 months postoperatively. The postoperative margin reflex distance 1 measured 3.8 mm for both eyes.

案例 18.一個26歲的女性患者進行上瞼下垂矯正與上瞼提肌腱膜–通過三部分切口進行的穆勒肌複雜手術。(上圖)術前，邊緣反射距離是右眼0.5毫米以及左眼0.8毫米。 (下圖) 照片顯示術後8個月，雙眼的邊緣反射距離都是3.8毫米。

Case 19. A 27-year-old male patient underwent blepharoptosis correction with the levator aponeurosis–Müller muscle complex advancement with three partial incisions. (Above) The preoperative margin reflex distance 1 measured 0.6 mm for the right eye and 0.3 mm for the left eye. (Below) Photograph obtained 8 months postoperatively. The postoperative margin reflex distance 1 measured 3.7 mm for the left eye and 3.4 mm for the right eye.

案例 19.一個27歲的男性患者進行上瞼下垂矯正與上瞼提肌腱膜–通過三部分切口進行的穆勒肌複雜手術。(上圖)T術前，邊緣反射距離是右眼0.6毫米以及左眼0.3毫米. (下圖) 照片顯示術後8個月，左眼的邊緣反射距離都是3.7毫米，右眼的邊緣反射距離是3.4毫米。

（案例17-19均引用自PRS論文《Blepharoptosis Correction: Levator Aponeurosis–Müller Muscle Complex Advancement with Three Partial Incisions》）

以上案例都是引用自整形外科權威雜誌PRS上的學術案例圖片，是不是感覺和在美容院里看到的案例很不一樣？是不是感覺做完以後並沒有變得美艷不可方物？這就是真實、客觀的眼部整形手術結果。這畢竟只是在眼部的手術，直接改善的是眼部的審美，這不是全臉整形的手術，你面部其他的缺陷會依然存在，你不大可能僅僅做個雙眼皮就變成天仙，你看到的讓人心動的案例，要麼是患者本身就很漂亮，要麼是應用了「照騙」技術，那些妖艷案例不代表眼部整形手術的真實作用。

（本文由王說整形（WSHPlastic）原創發布）

「缺乏知識的決定往往是有缺陷的。最佳的決策需要知識。你知道的越多，你做出的選擇和決定越好。你做的決策和決定越好，你越將有可能得到一個好結果。」——廣州軍美醫療美容院長/美容主診醫師王世虎，諮詢請關注我的微信訂閱號「王說整形（WSHPlastic）」或微博「整形醫生王世虎」。