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失败双眼皮修复分析

2018-01-18 15页 doc 63KB 20阅读

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失败双眼皮修复分析失败双眼皮修复分析 双眼皮修复就是通过手术或非手术改善因为天生或是后天双眼皮手术导致的双眼皮重睑线不明显、部分及完全消失,双眼皮过宽或过窄、弧度中断、双侧不对称、双眼皮过厚,瘢痕增生、眼睑上抬困难、眼睑闭合不良等种种双眼皮所存在的问题。改善修复这些问题,使得双眼皮外观自然。 双眼皮失败的表现 适应症选择不当 不同的重睑术有不同的适应症,施术者和受术者都应该明确并非所有单睑都需要做重睑术,也不是所有单睑的人做成重睑都会增添美感。人们的容貌美并不完全取决于单睑或重睑,它与个人的脸型、眉型、眼型、耳型等协调统一有密切关系,...
失败双眼皮修复分析
失败双眼皮修复 双眼皮修复就是通过手术或非手术改善因为天生或是后天双眼皮手术导致的双眼皮重睑线不明显、部分及完全消失,双眼皮过宽或过窄、弧度中断、双侧不对称、双眼皮过厚,瘢痕增生、眼睑上抬困难、眼睑闭合不良等种种双眼皮所存在的问题。改善修复这些问题,使得双眼皮外观自然。 双眼皮失败的现 适应症选择不当 不同的重睑术有不同的适应症,施术者和受术者都应该明确并非所有单睑都需要做重睑术,也不是所有单睑的人做成重睑都会增添美感。人们的容貌美并不完全取决于单睑或重睑,它与个人的脸型、眉型、眼型、耳型等协调统一有密切关系,而且还与个人的性格、气质、表情等有一定关系。有些人单睑细长、明媚,与五官、面容和谐匹配,显得文雅秀美、自然,就不需要做重睑术。 术前形态不适当 正确的重睑线及其形态设计是保证重睑美容成功的前提。设计时不认真或不采用正确的设计,必然导致重睑线过高或过低、双侧不对称、重睑线形态不良等问题。设计总的原则是,要根据患者的脸型、睑裂长短、鼻梁高低等,既要注意其宽度,还要考虑其长度、弧度及术后欲形成的重睑形态而综合考虑。此外,设计时一定要让患者积极参与,并征得其家属或第三者同意。 术式选择不当 术式选择不当是造成重睑美容效果不佳或失败的另一个主要原因。选择术式应根据患者脸型、各种术式应用范围及术者的习惯和经验综合考虑,不能千篇一律地采用一种术式解决所有问题。 操作粗疏 重睑术是一种精细、技巧要求高的美容外科手术,施术者一定要具有严肃认真、一丝不苟的医疗作风和科学态度。除术前认真做好各项必要准备外,术中一定要严格无菌操作,动作要轻巧准确,避免粗暴、草率,只有这样才能保证手术成功和达到术后效果满意。 双眼皮修复方法 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 术后重睑线不明显 受术者在整个睁眼过程中其重睑皱襞线都不明显,或部分明显、部分不明显,这在用埋线法做重睑术者是由于所埋线未带住睑板所致;在用缝线压垫结扎法者是由于缝线结扎不紧,未使睑板与皮肤发生粘连所致;在用切开法者是去除眼轮匝肌、睑板前脂肪、眶隔脂肪不够,使上睑皮肤与睑板粘合不牢所致。 再修复方法: (1)整个重睑线不明显者,需要重做手术。 (2)重睑线部分不明显者,对用间断埋线法和缝线压垫结扎法的只需在不明显部分再间断埋线或再间断缝线压垫结扎即可;对用切开法出现部分重睑线不明显的,也可以使用部分埋线法、缝线压垫结扎法修复。 (3)重睑线不明显者,还要考虑选择的手术方式是否符合本人的眼部条件。一般说来,眼皮较薄的年轻人及内眦赘皮较轻的人,可以选用埋线法或缝线压垫结扎法修复。如果受术者用埋线法或缝线压垫结扎法出现重睑线不明显,而受术者又是肿眼泡或有严重的内眦赘皮或有明显的上睑皮肤松弛者,应改用切开法修复。采用切开法修复时,也应注意带住睑板或睑板前筋膜,修整内眦赘皮,去除过多的上睑松弛皮肤,这样重睑线才会明显。 重睑过宽过窄或不对称 出现重睑过宽、过窄或不对称的原因,主要是重睑线设计得不恰当。重睑线设计在9,10 mm宽时,或切除上睑松弛皮肤过多时,常常会使重睑过宽(个别演员特殊要求除外);重睑线设计在6mm以下时,近期重睑线尚属自然美观,但过3个月之后重睑线会显得过窄,而出现所谓的“隐双”,这对某些受术者尚可接受,而某些受术者会不满则要求修复。 双侧重睑不对称的原因是: ?术前设计线画得左右不对称(常未用尺子和分规测量画线); ?术中左右眼睑皮肤固定在睑板的高度不一; ?未注意术前受术者存在双眼不对称现象,而设计时又未注意调整重睑设计线。 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 再修复方法: (1)对重睑过宽者,目前尚无良方。因此,术前设计如受术者没有特殊要求,睑宽以7,8mm为好。在术中,应正对切口下缘带睑板缝合,不可过高。由于皮肤有一定的伸缩性,因此对重睑过宽不满意者,可让其每天用手指牵拉重睑线上的上睑皮肤,当这部分皮肤松弛下垂后,可遮住过宽的重睑,一般经过2,3个月的牵拉,重睑宽度可变窄一些。必要时,可重新设计低线,按三眼皮修复法修复(见后)。 (2)对重睑过窄者可用切开法按原重睑线切开,分离重睑线以下的上睑皮肤,使之达灰线,然后在带睑板缝合时,可选在切口上缘一点的部位,这样缝合的结果重睑会变宽一些。如果受术者上睑皮肤松弛,则还要去除适当的皮肤,才会使重睑宽一些,否则松弛的上睑皮肤下垂会遮住重睑线使得重睑过窄。 (3)对双睑左右不对称者,一般可采用切开法将窄的重睑修整与对侧的重睑一致。如果一侧过宽而对侧尚可,则用牵拉皮肤的办法将宽侧眼睑皮肤牵拉至松弛而与对侧一致。 重睑线较短 重睑线较短者有两种情况 ?近内眦部一端重睑线消失,形成所谓“半双”眼皮,这是由于内眦赘皮遮盖所致; ?外眦部重睑线消失,这有二方面原因:一是设计线时未达眶缘部,二是缝外面一针时用压线法者压得不够紧,用埋线法或切开法者则带深部组织不够。 再修复方法 半双眼皮要改成全双眼皮,需要修整内眦,一般采用“Z”成形法即可矫正;开大内眦(见内眦赘皮一节)、外眦部重睑线不显的,可以采取埋线法延长一针的距离即可。用切开法修复时,外侧一针应缝在筋膜或骨膜上。 三眼皮 重睑术后出现三睑者(即比一般重睑多一至两个皱褶),称三眼皮,这只见于行切开重睑术者。其发生的原因,系切开眶隔、剪去眶隔脂肪以后,眶隔创面直接与重睑切口上方的皮肤粘连。因此,术中应尽可能保留切口上方之皮下组织及眼轮匝肌,以避免眶隔缘直接与皮肤粘连。 再修复方法 轻度而早期的三眼皮畸形者,可牵拉其上睑皮肤,使粘连松脱;重者需手术修复。修复方法为按原重睑线切开皮肤,向上剥离,使粘连的皱褶松解;然后将切口下缘皮肤向上超过原睑板缝合点与睑板缝合;再与切口上缘皮肤缝合打结,经7天拆线。 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 三角眼 这是由于设计重睑线时内眦段设计过宽,以致术后睁眼时此段不能与睑缘一同提起。 再修复方法:可重新设计重睑线,加宽重睑线中段和外侧的宽度。手术方法为按原重睑线切开皮肤,将切口上缘中段和外侧的上睑皮肤去除一部分,使得内、中、外一样宽或内窄外宽,然后缝合,最后可形成平行型双眼皮或广尾型双眼皮。 皮下结节 这只见于行埋线法重睑术者。其原因: ?缝线经过皮下时离表皮过近; ?没有从原针眼回针,使部分表皮被结扎在线结内。 再修复方法 有的线头离表皮较近,可在重睑线形成后拆除线结,或者用切开法切除皮下线结,重新按切开法做双眼皮。 双眼皮修复失败的原因 埋线重睑,脱落或未出现重睑 切开或埋线法重睑,因吸脂过多至眼窝凹陷多皱,外观衰老 双眼皮过宽,过窄,过长,过短,双侧不对称 原因为设计不当,设计线过宽,过窄过长,过短,双侧不对称,切开时未按设计线切开;设计时未考虑患者本身双侧不对称。 三眼皮形成 原因为原有双眼皮粘连线未分开,原有双眼皮线与新设计的双眼皮线形成三眼皮,多见application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 于埋线法;切口上方眼轮匝肌去除过多,致使上睑皮肤与深部组织粘连形成三眼皮。 外形不美 患者眼裂短,形成双眼皮宽,眼睛变圆;切口下缘眼轮切除不够双眼皮臃肿不自然;双眼皮外形与五官不协调。 睁眼乏力 术前患者有轻度上睑下垂或提上睑肌力弱;术中切开过深,损伤提上睑肌腱膜;早期疤痕增生挛缩可引起。 双眼皮线消失 原因为双眼皮设计线过低形成内双;睑板前眼轮匝肌去除不够,妨碍皮肤与睑板粘连;缝合时没固定于睑板腱膜上;拆线过早粘连不够牢固。 切口疤痕 原因为切口感染,切口缘不整齐,对合不良,或患者是疤痕体质。 切开重睑过宽,睑沟眼轮匝肌堆积,睑沟过厚 上睑松皮压至睫毛,有水肿,眼神呆板。反复修复过几次,仍未改变,反而愈宽、厚、重、形态更不好,皱襞瘢痕加宽,睑皮下纤维组织提取过多粘连过薄。 切开重睑过宽,修复过数多次 眼轮匝肌及纤维组织提取过多,造成重睑沟大面积粘连,皱襞疤痕过长超过外眦长度。形成多层皱襞,整体睑沟纤维化僵硬无弹性,疤痕凹凸不平。 双眼皮术后护理 1. 保持伤口清洁,防止感染。重睑术后的伤口清洁是很重要的,如果伤口不干净,很容易发生感染,造成双眼皮伤口疤痕的形成。所以术后洗脸时注意不要打湿伤口。手术后1,2天可摘掉眼睛上包扎的敷料,如果伤口上有血痂或分泌物,可用无菌盐水或医用酒精擦拭。 2. 手术伤口出血、淤血或血肿的防治。如果手术中损伤了小血管或术中止血不彻底,术后眼睛遭到外部撞击,激烈运动或变化无常的情绪都会引起伤口出血、淤血或血肿。为防止上述并发症的发生,可对局部伤口加压包扎或用冰袋冷敷,但压力不宜大,以免损伤眼睛。 3. 术后应在安静舒适的环境休养。室内空气要清新流通并保持一定温度。在饮食上增加蛋白质的摄取量,同时多吃水果和新鲜蔬菜。术后1周内不要看电视、报纸,卧床休息时最好半卧位(把枕头垫高),以免眼睛过度疲劳或头部位置过低而加重伤口肿胀。 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 4. 手术当日伤口会有些疼痛,但随着时间的推移会逐渐减轻。病人不要急于吃去痛片,因为阿斯匹林类药物会加重伤口出血。 5. 做重睑切开术后的病人,术后5,7天拆线。有时拆线后伤口内会留有极小的线头,随着时间的推移,线头会慢慢地顶出来或自行吸收。 埋线法重睑术后缝线部位起硬结多见于以下两种情况:手术后2,3天,缝线部位红肿明显。这种情况提示感染的可能性大,一定要及早就诊,及时开放引流,去除缝线,否则感染不易控制。同时局部用抗生素眼药,口服或肌肉注射抗生素。如果针眼周围皮肤发红,稍有硬结。这是正常反应,可以不做特殊处理;另一种情况是术后1周或更长时间,缝线部位皮肤总有硬结,这种情况多见于线结包埋不全,刺激皮肤组织产生慢性炎症反应所致。治疗上可局部理疗、局部外涂一些去炎松软膏并加以热敷等,一般均可自行吸收而不留后遗症。如果效果不佳,则可以考虑去除缝线。 双眼皮修复手术原则 1、认真分析前次手术失败的原因。 2、重新设计双眼皮切开线,尽量将原切口疤痕全部切除。 3、去尽睑板前疤痕,充分分离肌肉与睑板前腱膜的粘连。 4、缝合时弧线流畅自然,睑板前腱膜固定牢靠。 5、前次手术眶隔脂肪去除过多时可释放内侧脂肪,或游离移植下睑眶隔脂肪,或分次 注射自体脂肪。 6、手术时要爱护组织,轻柔微创,缩短恢复期并减少疤痕增生。 双眼皮修复的最佳时间 除了眼睑严重闭合不良的病例外,其余患者均应在手术后半年至一年、瘢痕软化后才可考虑施行矫正手术。若在瘢痕软化前手术,因为组织较脆弱,容易产生撕裂,导致瘢痕形成,从而影响手术效果。 做双眼皮修复不分任何季节的,什么时候做都可以,只要选择好医院和医生就可以。 双眼皮修复前的准备 1、认真分析前次手术失败的原因。 2、重新设计双眼皮切开线,尽量将原切口疤痕全部切除。 3、医生检查受术者是否符合手术要求,若患有割双眼皮手术的禁忌症则不能手术。关于术后效果,与医生做充分沟通。 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check 4、在术前两周,要禁烟、禁酒、避免口服如阿司匹林或含阿司匹林的药物、有活血功能的中成药物等。 5、尽量了解手术的风险和可能出现的病发症,做好万一出现这些病发症的心理准备。 6、术前准备太阳镜(遮掩伤痕)、冰袋(术后冰敷伤口用)等物品。 7、女性要避开经期和孕期进行手术。 8、术前不化妆。 意点 双眼皮修复手术注 一:做双眼皮修复手术必须在术后一周内或术后半年,以防止对眼部造成伤害。 二:要对双眼皮修复失败的原因进行思考,确定,在修复的时候加以弥补。 三:重新制定双眼皮修复方案,做到讲原来的切口留下的疤痕切除干净。 四:双眼皮修复手术时要使弧线流畅呈现自然状态。并且重新布线,不能再出现三层双眼皮的情况。 五:双眼皮修复手术时最好辅助一些自体脂肪的注射,保证眼部的饱满。 双眼皮修复的价格 1、双眼皮修复价格与失败程度有关:双眼皮修复的技术难度要看双眼皮失败的程度,越严重的话修复难度越大,当然价格也会高,而一般双眼皮修复价格比第一次做双眼皮要高,所以双眼皮修复价格是多少钱要高于做双眼皮;双眼皮修复的难度越高,做双眼皮修复价格是多少钱越高,如,第一次双眼皮修复多少钱一般要低于二次和三次双眼皮修复价格。 2、双眼皮修复价格与医院有关:双眼皮修复需要多少钱,医院的实力决定医院的级别,而因为医院的实力不同对于收费的标谁也是有一定的差异的,这也是对双眼皮修复价格是多少钱产生影响的原因。 3、双眼皮修复价格跟所选专家有关:专家的实力与技术肯定是得到众多爱美女性所认可的,这样就说明专家的价值所在了,而对于一个不知名的医师而言,在这方面肯定要欠缺一些,这是众多临床经验积累出来的,因此选择专家与医师,对做双眼皮修复价格是多少钱肯定是有影响的。 application; infection and antibacterial drug of clinical application; transfusion refers to levy; nutrition support of adapted card and clinical application; common life support technology (as cycle breathing support, and nutrition support,) and emergency technology of application; common guardianship instrument using. Look: shock, cardiac respiratory arrest and acute organ failure, systemic inflammatory response syndrome and severe infection and multiple organ dysfunction syndrome (MODS), severe disturbance of body fluid environment such as critical theory and progress of the illness. 2. basic requirements (1) species and cases of study requirements: severe pneumonia in disease-disease myocardial infarction ... 3. high requirements (1) learning disease species: disease species disease species image radiation: rheumatic heart congenital heart intestinal Crohn's (Crohn) disease intestinal tuberculosis bile duct cancer chronic pancreatic inflammatory urinary system stone urinary system tumor adrenal disease thyroid disease cranial within infection nervous system tumor nuclear medical: Digest road bleeding explicit like brain blood flow perfusion explicit like testicular blood pool explicit like salivary glands explicit like (2) clinical knowledge, and skills requirements: understand various image check
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