Facial depression occurs due to a variety of reasons, which often affect the appearance of the face more severely due to facial asymmetry. In recent years, with the development of plastic surgery technology, facial depressions can also be filled by plastic surgery techniques, and due to the development of filling materials and technological progress, it has made possible the repair of facial depressions without leaving marks. Due to the difference in materials used, it is mainly divided into two categories: self-material repair and artificial material repair. The following editors will introduce some knowledge about the filling of facial depressions with silicone films.
Solid silicone tablets are mainly suitable for congenital depressions in the bone, small congenital depressions in the forehead and traumatic bone depressions. It can also be used for zygomatic arch and peri-orbital bony depression. Here, the correction method for congenital depression of the temporal part is mainly introduced. The other parts are basically the same as the temporal filling, but it is best to fill the layer between the periosteum and soft tissue.
First estimate and measure the extent and depth of the depression area of the face. When observing and measuring, you should pay attention to the depression degree and the area of the temporal area on both sides. In addition, the depressions in the hairline do not have to be filled, because the hair can be covered, and the filled silicone sheet is a foreign body. In principle, it should be as small as possible and thinner, so the tissue irritation is relatively small. The complications are also relatively small.
After measuring the salamander, draw the size of the recessed area with gentian purple, and fix it with coriander wine. Then it is best to first use dental impression rubber foam to take hot water and then take samples to make a filling model that conforms to the size and shape of the depression. Generally, the disc-shaped middle thick edge is thin. Then use a solid silicone rubber block to sculpt the official filling model according to the impression rubber sample. It should be slightly thinner than the sample, and the periphery should be as thin as possible. Otherwise, it is often felt that the part is too full after filling, especially after the envelope is formed, and the edge contour is obvious. Double temporal intra-hairline incisions, 1 to 1.5 cm from the hairline margin, and about 3 to 4 cm long. Before surgery, the hair on both sides of the incision was 3-4cm wide. After local anesthesia, the scalp and cap-shaped diaphragm were cut, and the scalp was clamped to stop bleeding.
Fillers can be placed subcutaneously, supertemporally and deep temporal fascia, or under temporal fascia. Therefore, peeling can be performed at the above-mentioned levels, and the range can be according to the size of a predetermined range. It is too shallow under the skin, the foreign body sensation is more obvious, and the contour of the edge is more obvious. Although the above problem is placed under the temporal muscle fascia, due to the limitation of the attachment of the temporal muscle fascia to the skull, the model cannot be placed in the front of the depression, and the tension of the temporal muscle fascia is large, making the model difficult to sew and fix.. Superficial temporal and deep fascia, the superficial temporal fascia is the better level, but the frontal branch of the facial nerve is located in the deep layer of the superficial fascia into the deep temporal fascia. Care should be taken when cutting the two fascias Do not damage the nerve. The body surface projecti on of the frontal branch of the facial nerve is the line connecting the midpoint of the line connecting the outer ear and the foot with the outer end of the eyebrow at 1.5 cm, behind this line, that is, behind the temporal artery frontal branch is the safety zone. The superficial temporal deep fascia should be incised in the safe area, and separated along the temporal plane of the temporalis fascia temporally, and the separation range is slightly larger than the model plane. This level of tissue is loose, easily separated , and generally does not bleed. Once the bleeding point is found during the separation process, it should be ligated or electrocoagulated to stop bleeding. After the cavity is separated, put the silicone model piece into the cavity.
After the model was placed and stabilized, the posterior upper edge was sutured with the temporal muscle fascia with two wires. Then the superficial temporal and deep fascia were reset and covered on the model, and several stitches were sutured with 0-gauge thread. The skin was sutured with 3/0 sutures, and gauze bandages were applied and fixed for 2 days, and sutures were removed for 1 week.
1. The size and thickness of the silicone sheet play an important role in the shape of the filling bone depression. Too small, too thin bone depression can not be corrected, and too large and too thick can lead to tissue stimulation, leading to rejection , so when After implantation, observe the morphology and touch the part with your hands. It is better to fill the cavity with the silicone sheet naturally and just right. If you are not satisfied, you should take it out again and trim it.
2. Silicone tablets are generally hard, and it is difficult to fit the neck depression completely. In order to make the silicone sheet fit closely with the depression, the silicone sheet should be cut with a blade to make a few horizontal and vertical cuts to loosen it but not to cut it.
3. After the silicone sheet is filled, if the Ying shallow deep fascia cannot be stitched together, it may not be sutured.
1. Hematoma: Hematoma may be caused by bleeding when the local pain is obvious. At this time, the dressing should be opened. After the hematoma is determined, the incision should be opened to remove the model, remove the swelling, completely stop the bleeding, and then implant the silicone sheet.
Serum 2. Seroma: The wound exudes clear liquid. This kind of situation is more common on one side, because it is implanted only under the skin, which causes the prosthesis to move and stimulate the tissue, or it is caused by bringing in a thread or foreign matter such as talcum powder. In this case, the drainage and release of serum swollen fluid often does not solve the problem, and it should be removed and put back next time, and it is better to put it in a deeper level .
3. Unsatisfactory appearance: due to slippage of the prosthesis or poor dissection of the cavity, too small prosthesis. Therefore, the prosthesis should be fixed, including internal and external fixation. The external fixation is usually wrapped with gauze and removed within 3 to 5 days.
4. Rejection reaction: Both sides are red and swollen, the body is exposed, and there are no other reasons to find, it should be determined as silica gel rejection reaction. At this point, the prosthesis should be removed and redone using another method .
Experts suggest that you must go to a regular plastic surgery hospital for inspection first, and ask a professional physician to design a treatment plan for facial depression according to your specific situation, and then perform treatment, so as to ensure the safety and effectiveness of the surgery. If you have any further questions,