【 文献重点摘要 】
 

Background: Accurate preoperative planning combined with facial fat compartment augmentation can improve precision and balance in facial rejuvenation techniques. Understanding the concept of “facial shaping” with respect to symmetry and soft-tissue (fat) distribution preoperatively is critical to optimizing aesthetic outcomes in various face lift techniques.

Methods: A review of 822 consecutive face lifts performed from January of 1994 to June of 2007 by a single surgeon (R.J.R.) was conducted. From this database, randomly selected cohorts of 50 preoperative and postoperative photographs were critically analyzed by three plastic surgeons exclusive of the senior surgeon (R.J.R.). Three facial parameters were compared on each facial side: facial height, degree of malar deflation, and orbit size. Long-term improvement was evaluated to delineate factors contributing to success in creating an aesthetically balanced facial shape.

Results: Asymmetry between the two facial sides was noted in every patient preoperatively with respect to the three study parameters and was improved postoperatively. There was no statistically significant interobserver bias in the evaluations (p < 0.005). Facial asymmetry dictated differential treatment of the superficial musculoaponeurotic system (SMAS) tissue between facial sides to achieve the desired youthful facial shape. The angle (vector) and extent of SMAS-stacking varied depending on the preoperative analysis. Similarly, the selection of SMAS-ectomy versus SMAS-stacking depended on the degree of malar deflation and resultant cheek fullness.

Conclusions: Proper preoperative analysis for evaluating facial shape should address (1) facial height, (2) facial width, and (3) overall distribution/location of facial fullness. This method of evaluating facial shape and symmetry is simple and reproducible, and can aid in formulating a comprehensive treatment plan.

背景：精确术前计划结合面部脂肪室扩大可以提高面部年轻化技术的精确性和平衡性。了解“面部整形”的概念与术前的对称性和软组织(脂肪)分布有关，对于优化各种面部拉皮技术的美学效果至关重要。

方法：回顾1994年1月至2007年6月由一名外科医生(R.J.R.)连续进行的822例面部提升手术。是进行的。从这个数据库中，随机选择了50张术前和术后照片的队列，由除资深外科医生(R.J.R.)之外的三位整形外科医生进行了严格的分析。比较每侧面部的三个参数：面部高度、颧骨收缩程度和眼眶大小。对长期的改善进行了评估，以勾勒出有助于成功创造审美平衡脸型的因素。

结果：所有患者术前在三项研究参数上均发现两侧面部不对称，术后均有改善。在评估中没有显著的观察者间偏倚(p<0.005)。面部不对称要求对面部两侧之间的浅表肌肉腱膜系统(SMAS)组织进行区别处理，以获得所需的年轻脸型。SMAS堆积的角度(矢量)和程度随术前分析的不同而不同。类似地，SMAS切除还是SMAS堆积的选择取决于颧骨放气的程度和由此产生的面颊饱满程度。

结论：正确的术前分析应考虑(1)面部高度，(2)面部宽度，(3)面部饱满的总体分布/位置。这种评估面部形状和对称性的方法简单，重复性好，可以帮助制定全面的治疗计划。