察爾斯大夫 美麗殿堂 Dr. Charles Meridien Palace

Vertical Subperiosteal Mid-face-lift for Treatment of Malar Festoons（5）

Results

The median observation time was 12 months. The procedure on average took 2 h 40 min ± 25 min. Immediate healing was achieved without major complications, adverse reactions, or side effects. Edema remained for 10–12 days.

No alopecia was observed; no swelling or seromatous fluid collection necessitated a second procedure or prolonged drainage. Three patients showed a very small intraoral wound dehiscence of 3-5 mm, two on the left side and one on the right side. Using daily local irrigation, the wound healed by secondary intention after 7 days. All patients were judged to have satisfactory cheek elevation and enhanced contour without evidence of recurrent festoons, ptosis, or loss of fixation. The patients did not complain of pain in the treated area 3 days after surgery. They did not take painkillers for more than 2 days after surgery.

The surgical outcome was evaluated by analyzing photographs taken before and after surgery, and by analyzing pre- and postoperative measurements. Despite that 6 months after surgery drooping of the lateral brow position was observed at a mean of 2.3 mm, the technique we used achieved a significant rejuvenation of the midface and the malar festoons (Table 1). The examples seen in Figs. 13, ​,14,14, ​,15,15, ​,16,16, and ​and1717 illustrate the indications and results.

Table 1

Pre- and postoperative evaluation of the position of the nasojugal groove after a vertical upper-midface lift (SUM-lift) (N = 12)   

Preoperative 6-month postoperative 12-month postoperative

AB (cm) 5.8 ± 0.4        6.3 ± 0.3                6.0 ± 0.3

AB distance between the oral commissure and the nasojugal groove position

Pre- and postoperative evaluation of the position of the nasojugal groove after a vertical upper-midface lift (SUM-lift) (N = 12)

Fig. 13

a, c Preoperative views of a 54-year-old patient with ptosis of the malar tissues, hollowing of the infraorbital area and the cheek area, lengthening of the lower eyelid, attendant tear-trough deformity, and associated nasojugal grooves, nasolabial folds, ...

Fig. 14

a, c Preoperative views of a 48-year-old patient. He demonstrates ptosis of the malar tissues, loose festoons, hollowing of the infraorbital area, lengthening of the lower eyelid, attendant tear-trough deformity, and nasojugal grooves. b, d Six months ...

Fig. 15

a Preoperative view of a 56-year-old patient with marked loose festoons and deep nasojugal grooves. b Postoperative view 12 months after vertical upper-midface lift (SUM-lift) procedure. Note the improvement of the malar bags

Fig. 16

a Preoperative frontal view of a 58-year-old woman. She has marked malar festoons with ptosis of the malar tissues, hollowing of the infraorbital area and the cheek area, lengthening of the lower eyelid, attendant tear-trough deformity, and nasolabial ...

Vertical Subperiosteal Mid-face-lift for Treatment of Malar Festoons（4）

Patients

Twelve patients (3 males and 9 females, age = 47 ± 6 years) underwent a SUM-lift between 2006 and 2007 for treatment of malar festoons. The procedure included simultaneous lower blepharoplasty and video-assisted trans-temporal subperiosteal and sub-SMAS tissue release. All patients underwent a thorough, individualized preoperative evaluation to establish a correct diagnosis, evaluate asymmetries, estimate the degree of tissue repositioning, and decide on the level of fixation. In all patients, the distances of the marginal rim of the lower lid and the nasojugal grooves between defined points were measured preoperatively (Fig. 12a) and 6 and 12 months after surgery (Fig. 12b). Therefore, measurements were taken along a perpendicular line from the lateral limbus of the eye to a horizontal line of the oral commissure (Fig. 12a) to analyze the preoperative and postoperative positions of the most inferior point of the nasojugal groove (Fig. 12b).

Fig. 12

Schematic evaluating the position of the nasojugal groove. Measurements were taken along a perpendicular line from the lateral limbus of the eye to a horizontal line of the oral commissure (A) to analyze the preoperative position of the nasojugal groove ...

Vertical Subperiosteal Mid-face-lift for Treatment of Malar Festoons（3）

The soft tissue of the cheek is freed from underlying bone through a buccal incision placed from the molar to the canine to leave an adequate cuff of gingiva for closure (Fig. 4). Subperiosteal dissection is performed on the maxilla and zygoma using a custom-made periosteal rasp. The dissection extends from the nasal spine to the lateral buttress of the maxilla. It frees the tissue around the pyriform aperture, over the frontal process of the maxilla, along the inferior and lateral orbital rim, around the infraorbital nerve, then vertically up to the frontal process of the zygoma to the level of the lateral canthus, and laterally over the zygoma body to the zygomatic arch (Fig. 5). Freeing is performed over the anterior two thirds of the zygomatic arch. Release of the arcus marginalis is especially important for correcting the tear-trough deformity and elevation of the lid-cheek interface, just as freeing from the nasal spine and pyriform aperture is important for elevation of the upper lip and corners of the mouth.

Fig. 4

Intraoperative view of a patient undergoing a vertical upper-midface lift (SUM-lift); enoral view after degloving the maxilla, the zygoma, and two thirds of the zygoma arch. The suction cannula points to the sensitive zygomatic nerve

Fig. 5

Intraoperative view of a patient undergoing a vertical upper-midface lift (SUM-lift). The soft tissue of the cheek is freed from underlying bone through a buccal incision using a custom-made periosteal rasp. The dissection extends from the nasal spine ...

Once the soft tissue had been thoroughly freed, elevation of the midface begins by insertion of two 2 × 0 PDS sutures by an intraoral approach, taking a deep bite of the soft tissue (Fig. 6). The area for the cheek tissue suture fixation placement was marked previously; it is a cross in the medial cheek located at the intersection of a vertical line dropped from the lateral canthus and a transverse line directed from the lowest aspect of the alar groove at its intersection with the lip. The vector of suspension is determined entirely by the position of the key area relative to the point of bony zygomatic divergence. The patient’s head is turned to the side and a retractor is inserted through the short scalp incision into the temporal fossa. The patient’s head is straightened. The sutures are advanced up by suspending the cheek to the desired position until the identifying premolar show confirms adequate mobilization (Fig. 7a, b). The effects are assessed for symmetry and the sutures are fixed into the deep temporal fascia (Figs. 8 and and9).9). This superior vertical elevation lifts the deep tissues, which are maintained in the proper position of the fixed sutures. Most important is the production of a large soft tissue volumetric mass in the malar and submalar regions (Fig. 9). The distal end of the sutures with their multiple knots is trimmed and secured with a 4 × 0 Vicryl suture to lay flat in the temporal fossa, avoiding any discomfort of the sticky sutures.

Fig. 6

Intraoperative view of a patient undergoing a vertical upper-midface lift (SUM-lift). The area for the cheek tissue fixation placement is marked. It presents as a cross in the medial cheek located at the intersection of a vertical line dropped from the ...

Fig. 7a, 7b

Intraoperative oblique view of a patient undergoing a vertical upper-midface lift. The midfacial tissues are elevated until identifying premolars confirms adequate mobilization to the desired position by applying tension to the sutures exiting the ...

Fig. 8

Intraoperative view of a patient undergoing a vertical upper-midface lift. Superior vertical elevation produces a large soft tissue volumetric mass in the malar region. It is most important to assess large soft tissue volumetric mass production in the ...

Fig. 9

Intraoperative view of a patient undergoing a vertical upper-midface lift. After mobilizing the midface tissues and the SMAS fascia, the mesotemporalis fascia is repositioned, suspended after suture fixation, suspending the midface tissue to the deep ...

In addition, the frontotemporal skin is lifted in a vertical direction and is also anchored to the temporal fascia. Several interrupted sutures are secured to the temporal fascia at the level of the access incision, allowing an open knotting technique and secure fixation of the flap (Fig. 9). After performing the midface elevation, a laterally based transposition orbicularis muscle flap, described by Hamra [15, 16], is used (Figs. 10 and ​and11);11); it is a safe and effective method to transmit a controlled amount of traction to the lower lid in lower blepharoplasty without the need for canthoplasty or canthopexy. The loose, redundant lower eyelid is meticulously removed without any muscle fibers. After meticulous homeostasis, the buccal sulcus is closed with interrupted sutures.

Fig. 10

Illustration of the vertical upper-midface lift with the suspension sutures in place. Note the suspension of the soft tissue at the inferior lateral orbital rim area.

Fig. 11

Intraoperative view of the suspension sutures placed in the soft tissue at the inferior lateral orbital rim area after dissection of the orbicularis muscle for septal release and muscle suspension.

Vertical Subperiosteal Mid-face-lift for Treatment of Malar Festoons（2）

Method

Indications

Video-assisted endoscopic Subperiosteal vertical upper-midface lift（SUM-lift）in conjunction with a Lower blepharoplasty and/or endoscopy-assisted Forehead plasty, if needed, is indicated in patients with moderate skin elasticity and festoons which cannot be treated by high SMAS rotation advancement surgery alone and in patients who already have undergone a traditional face-lift procedure. Patients who exhibit a vertical descent of the midface（malar flatness, festoons, malar bags）, including an oval configuration to the orbit, elongation of the lower eyelid skin, concomitant ptosis of the composite flap, including skin, muscle, and fat, prominent nasolabial fold, and early jowl formation, are ideal candidates for this procedure. Prior lower blepharoplasty patients who exhibit lid retraction and scleral show also may be improved by advancement of this upper-midface procedure [5–14].

Surgical Techniques

The procedures routinely have been performed under general anesthesia, with local anesthesia infiltration for homeostasis and perioperative intravenous antibiotics (Augmentin®, GlaxoSmithKline) for 48 h. No anticoagulation therapy was performed. Infiltration of the area was performed with a vasoconstricting solution consisting of 1 ml of 1:1000 epinephrine in 1000 ml of normal saline. Markings were performed preoperatively with the patient in a sitting position. If an upper blepharoplasty was needed, the eyebrow was held at the desired level. The redundant upper-eyelid skin was marked with the brow in an elevated position to avoid over resection. The center of the forehead at the region of the glabella was infiltrated, as were the corrugators and procerus muscles to obtain adequate vasoconstriction in the area to be dissected. The anterior temporal crest was infiltrated to produce hydrodissection and improve visualization. The infiltration continued laterally over the superior lateral orbital rim to the lateral canthus into the upper midface and the buccal sulcus.

For the forehead and upper-midface rejuvenation, six access incisions are used. The surgery is performed with a 4-mm, 30° down scope, with a protection sleeve and irrigation system to keep the field clean. The operation begins by elevating the forehead through two 2-cm sagittal incisions 1 cm behind the anterior scalp line and a standard subperiosteal forehead plasty is performed. The average lateral brow lift ranges between 4 and 6 mm as needed. For further correction of upper-eyelid pseudoptosis, loose skin of the upper lid in conjunction with a very small orbicularis oculi muscle fibers strip is resected. The protruding fat of the medial pocket is removed when needed.

Following the standard central forehead lift, the procedure proceeds to the lateral forehead and midface. The upper midface is elevated over the deep temporalis fascia (fascia temporalis profunda) in the scalp via a 3–4-cm transverse temporal incision 4 cm behind the anterior scalp in an open angle of about 120° toward the helical rim (Fig. 2). The incision is not parallel to the temporal hairline and is slightly perpendicular to the vector of repositioning. The lateral dissection extends over the deep temporalis fascia covering the temporalis muscle (sub-SMAS plane). This fascial layer is elevated with the forehead tissue by detaching it along the temporal crest by performing blunt dissection.

Fig. 2

Intraoperative view of a patient undergoing a vertical upper-midface lift (SUM-lift). The temporal incision is marked. The incision is curved slightly forward

Fig. 3

Intraoperative view of a patient undergoing a vertical upper-midface lift (SUM-lift). The endoscope is introduced under the temporal fascia into the upper midface. The scissor lies over the superficial temporal fascia and under the skin.

Next, from the temporal area over the deep temporalis fascia, the midface is approached sub-SMAS, dissecting subperiosteally inferior-lateral to the sentinel vein, between the sentinel vein and the zygomatic-temporal nerve (Fig. 3) (sensitive nerve), subperiosteally over the anterior surface of the

zygomatic arch (the facial nerve is on top of the elevator, over the fascia temporalis parietale), and entering the midface under the orbicularis oculi muscle. The dissection on the malar area is done subperiosteally under the orbicularis oculi muscle, leaving the septum orbitalis, infraorbital rim, suborbital oculi fat (pad), and zygomatic major muscle on top on the periosteal elevator.

麻豆變土豆醫美不願說的真相

作者：【記者蘇春瑛／台北報導】 | 台灣新生報 – 2014年5月12日

前陣子網路瘋傳一組大陸車模整容崩壞照，原本漂亮的麻豆臉蛋卻變成鬆垮凹凸不平的模樣，嚇壞許多人！想靠拉皮減去歲月痕跡卻變得眼歪嘴斜，施打雷射消除惱人紋路竟慘被灼傷，諸如此類的失敗案例時有所聞，醫師表示，不要為了愛美『修修臉』反變『羞羞臉』，術前應審慎與施作醫師進行完整的健康評估相當重要！

整形外科醫師安伯忠表示，民眾對醫美的接受度越來越高，其中又以想要改善臉部組織位移、拉提臉部線條的詢問度最高，而如以傳統拉皮雖然手術後維持時間較長，但因為需全身麻醉且手術傷疤長，恢復期也長所以風險相對提高，若是醫師經驗不足更可能傷到神經，造成口歪眼斜。

最新的3D時光線手術僅需局部麻醉且傷口小恢復期短，施作簡單能減少客人的恐懼感；另一種黃金微針電波因微針細小，在施作部位形成肉眼看不到的傷口，更是縮短傷口的癒合期，且因為深度較深能準確調整，熱能可有效的傳達到皮膚裡層，表皮所受熱能極少，比較不需擔心像電波拉皮引起的燙傷及疼痛等狀況。

安伯忠醫師提醒，選擇施做的醫療院所最好有國家美容醫學認證與整形專科訓練的醫師，手術前更要與醫師進行審慎完整的健康評估，本身有重大疾病如心臟病史、高血壓、嚴重糖尿病、肝腎功能受損或免疫系統異常等，都必須要向施作醫師仔細說明，唯有仔細挑選及細心評估，才不會愛美不成反而沒臉見人。

Vertical Subperiosteal Mid-face-lift for Treatment of Malar Festoons（1）

Aesthetic Plast Surg. Aug 2011; 35(4): 522–529.

Johannes Franz Hoenig,1,2 Daniel Knutti,1,2 and Antonio de la Fuente1,2

1University Hospital and Medical School of Goettingen, Robert-Koch-Street 40, 37075 Goettingen, Germany

2Department of Plastic and Aesthetic Surgery, Paracelsus Clinic, Hannover, Germany

Johannes Franz Hoenig, Email: info@professor-hoenig.de.

Published online Mar 17, 2011. doi: 10.1007/s00266-010-9650-3

PMCID: PMC3146709

（http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146709/）

（http://openi.nlm.nih.gov/detailedresult.php?img=3146709_266_2010_9650_Fig1_HTML&req=4）

Affiliation :

University Hospital and Medical School of Goettingen, Robert-Koch-Street 40, 37075 Goettingen, Germany. info@professor-hoenig.de

Keywords : Festoons, Malar membrane, Vertical subperiosteal midface lift, Malar mounds, Blepharoplasty

ABSTRACT

Background :

Malar mounds may be accentuated by chronic lid edema, with the development from malar Edema to malar Mounds and finally to malar Festoons. Because standard techniques do not seem effective and not specifically proposed for the treatment of malar festoons, subperiosteal vertical upper-midface lift associated with lower blepharoplasty overcomes these shortcomings.

Methods :

Twelve patients (3 males and 9 females, age = 47 ± 6 years) underwent Video-assisted endoscopic subperiosteal vertical upper-midface lift（SUM-lift）in conjunction with a lower blepharoplasty between 2006 and 2007 for treatment of malar festoons. This includes simultaneous lower blepharoplasties and video-assisted transtemporal subperiosteal and sub-SMAS tissue release.

Results :

All patients healed uneventfully without any major postoperative problems. The surgical outcome was evaluated according to the analysis of photographs obtained before and after surgery and the analysis of pre- and postoperative measurements. The technique we used（SUM-lift）achieved a significant rejuvenation of the midface and the malar festoons.

Conclusion :

Subperiosteal vertical midface lift resuspends and redrapes the facial network that originates at the level of the orbital rim. It seems to improve the permeability characteristics of the malar septum in the treatment of malar festoons and malar mounds by freeing the cheek tissue from underlying bone and redraping the malar septum. It is a reliable technique to improve malar mounds, palpebral bags, or festoons.

Introduction

During the aging process three variations of the infraorbital area may appear. Malar mounds, Palpebral bags, or Festoons (Fig. 1; see also Fig.

17a). Festoons are developmental Attenuation of the orbicularis

oculi muscle with Laxity of the attachments between the orbicularis and the deep fascia [1]. The orbicularis oculi muscle progressively sags until folds of muscle are suspended across the lower lid. Malar mounds in contrast are discrete soft tissue convexities that bulge directly outward from the malar prominence [2, 3]. They retain a relatively stable shape during usual facial movements, but can be worsened with smiling. Palpebral bags or Baggy eyelids develop at an early age and are also known as Herniated intraorbital fat [1]. They are the result of Intraorbital fat bulging outward against an attenuated or weak orbital septum of the upper or lower eyelid. Some of these changes cause functional and aesthetic problems for which surgical correction is a gratifying procedure, although surgical treatment of festoons, mostly seen in older patients who have lax supporting structures [1] in the preseptal area, orbital area, and the jugal region of the lower lid, is known to be difficult [1–5].

Fig. 1

1 = Festoons ; 2 = malar mounds; 3 = palpebral bags

Fig. 17

a. Preoperative view of a 48-year-old patient with marked malar festoons, redundant eyelid skin, and deep nasojugal grooves.

b. Postoperative view (14 months) after he underwent a vertical upper-midface lift (SUM-lift); the malar festoons are improved ...

Various surgical techniques have been used to treat malar bags and muscle festoons for the lower eyelid, taking into account its various etiologies. Pessa and Garza [2], who analyzed malar mounds and malar edema, found that the Malar septum acts as a relatively impermeable barrier that allows tissue edema to accumulate above its cutaneous insertion. Following their studies, this septum defines the lower “boundary” of several clinical entities, e.g., Malar mounds, Malar edema, Malar festoons. Therefore, malar mounds may be accentuated by chronic lid edema which may imply a time course in the progressive development from Malar edema to Malar mound and at least to Malar festoons [2].

Knowing that standard lower blepharoplasties cannot correct malar loops with muscle pouches, nor the sagging of the lower orbicular muscles (ptosis), and that standard techniques do not seem effective and are not specifically proposed for the treatment of malar festoons, subperiosteal vertical upper-midface lift associated with lower blepharoplasty overcomes these shortcomings. In this article we share our experiences with our technique.

Vertical Subperiosteal Mid-face-lift for Treatment of Malar Festoons

Aesthetic Plast Surg. Aug 2011; 35(4): 522–529.

Johannes Franz Hoenig,1,2 Daniel Knutti,1,2 and Antonio de la Fuente1,2

1University Hospital and Medical School of Goettingen, Robert-Koch-Street 40, 37075 Goettingen, Germany

2Department of Plastic and Aesthetic Surgery, Paracelsus Clinic, Hannover, Germany

Johannes Franz Hoenig, Email: info@professor-hoenig.de.

Published online Mar 17, 2011. doi: 10.1007/s00266-010-9650-3

PMCID: PMC3146709

（http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3146709/）

（http://openi.nlm.nih.gov/detailedresult.php?img=3146709_266_2010_9650_Fig1_HTML&req=4）

Affiliation :

University Hospital and Medical School of Goettingen, Robert-Koch-Street 40, 37075 Goettingen, Germany. info@professor-hoenig.de

Bottom Line :

Because standard techniques do not seem effective and not specifically proposed for the treatment of malar festoons, subperiosteal vertical upper-midface lift associated with lower blepharoplasty overcomes these shortcomings. The technique we used（SUM-lift）achieved a significant rejuvenation of the midface and the malar festoons. It is a reliable technique to improve malar mounds, palpebral bags, or festoons.

ABSTRACT

Background :

Malar mounds may be accentuated by chronic lid edema, with the development from malar Edema to malar Mounds and finally to malar Festoons. Because standard techniques do not seem effective and not specifically proposed for the treatment of malar festoons, subperiosteal vertical upper-midface lift associated with lower blepharoplasty overcomes these shortcomings.

Methods :

Twelve patients (3 males and 9 females, age = 47 ± 6 years) underwent Video-assisted endoscopic subperiosteal vertical upper-midface lift（SUM-lift）in conjunction with a lower blepharoplasty between 2006 and 2007 for treatment of malar festoons. This includes simultaneous lower blepharoplasties and video-assisted transtemporal subperiosteal and sub-SMAS tissue release.

Results :

All patients healed uneventfully without any major postoperative problems. The surgical outcome was evaluated according to the analysis of photographs obtained before and after surgery and the analysis of pre- and postoperative measurements. The technique we used（SUM-lift）achieved a significant rejuvenation of the midface and the malar festoons.

Conclusion :

Subperiosteal vertical midface lift resuspends and redrapes the facial network that originates at the level of the orbital rim. It seems to improve the permeability characteristics of the malar septum in the treatment of malar festoons and malar mounds by freeing the cheek tissue from underlying bone and redraping the malar septum. It is a reliable technique to improve malar mounds, palpebral bags, or festoons.

Fig1 : 1 = Festoons ; 2 = malar mounds; 3 = palpebral bags

Mentions : During the aging process three variations of the infraorbital area may appear. Malar mounds, Palpebral bags, or Festoons (Fig. 1; see also Fig. 17a). Festoons are developmental Attenuation of the orbicularis oculi muscle with Laxity of the attachments between the orbicularis and the deep fascia [1]. The orbicularis oculi muscle progressively sags until folds of muscle are suspended across the lower lid. Malar mounds in contrast are discrete soft tissue convexities that bulge directly outward from the malar prominence [2, 3]. They retain a relatively stable shape during usual facial movements, but can be worsened with smiling. Palpebral bags or Baggy eyelids develop at an early age and are also known as Herniated intraorbital fat [1]. They are the result of Intraorbital fat bulging outward against an attenuated or weak orbital septum of the upper or lower eyelid. Some of these changes cause functional and aesthetic problems for which surgical correction is a gratifying procedure, although Surgical treatment of festoons, mostly seen in older patients who have Lax supporting structures [1] in the preseptal area, orbital area, and the jugal region of the lower lid, is known to be difficult [1–5].Fig. 1.

還我小V臉！明星代言瘦臉產品真有效？

NOWnews – 2014年5月7日

生活中心／綜合報導

許多東方女性都渴望擁有一張巴掌小臉，因為可以給人秀氣、精緻的感覺，漂亮指數不用比就能先聲奪人。所以，為了一圓小臉夢，許多女性想盡辦法瘦臉，市面上也因而充斥著許多明星代言的小V臉拉提保養品；然而，有專業皮膚科醫師指出，這樣的方式是無法達到肌膚緊實及真正瘦小臉的目的。

皮膚科醫師黃政傑指出，現在市面上有許多燃脂產品標榜具有緊膚的功能，因此會讓人誤以為擦在臉上也同樣能滿足瘦小臉的需求；事實上，大多數這類產品的作用非常緩慢且微弱，在臨床上也幾乎看不到顯著的成果。

黃政傑醫師進一步說明，如果是早晨起床臉部有水腫的狀況，利用這類緊膚霜再搭配按摩的方式，或許有些許消腫的功能，但這充其量只是短暫的現象而已，並非是真正的「瘦小臉」，要單靠保養品來達到這個目的，其實是非常困難的，恐怕還得藉由醫美療程才能滿足需求。

至於市面上被使用於瘦小臉的醫美療程，黃政傑醫師表示，由於「電波拉皮」標榜無需動刀便可滿足肌膚緊緻的需求，目前最受到愛美的輕熟女或熟女們的青睞。事實上電波拉皮原本並非以「瘦小臉」為訴求，但因為該療程能使皮膚的膠原蛋白重組，讓膚況變得緊實、有彈性而帶動臉部肌膚自然往上拉提，使臉蛋看起來變尖、變小。

針對電波拉皮，黃政傑醫師指出，目前市場上所使用最新型的Thermage® CPT™第三代電波拉皮系統，因為搭配了新式的Total Tip電波塑顏橘色探頭，以及全新的冷卻與加熱技術，故除了治療的舒適度有所提升之外，能量也能均勻的傳導到更深層的組織。

黃政傑醫師解釋，由於該系統訴求可在無痛的狀態下滿足電波塑顏拉提的需求，且對於周細紋、兩頰嘴邊肉下垂嚴重，或是較豐腴臉型的治療成果較顯著，甚至標榜當下就能感受到肌膚平滑緊緻和漸進式的拉提，因此甫一推出就在市場上造成轟動，讓許多愛美人士趨之若鶩。

如果想要讓自己的臉看起來更小，黃政傑醫師建議，可考慮藉由搭配埋線拉提的方式；他說明，目前最新的粗線埋線方式，只需10多條線、以附帶的鉤子產生拉力而將皮膚往上拉提，就能達到尖臉與瘦小臉的作用；同時，粗線因為埋線不多，主要目的是以拉提為主，所以就算沒有埋線的地方，膚質仍然會變年輕、細緻且毛孔小，以滿足全面年輕化的需求。

不過，黃政傑醫師也提醒，除了未成年者不應進行任何非必要的美容相關手術外，消費者在進行醫療美容療程之前，務必要事先向專科醫師詳細諮詢，以瞭解自身的狀況並據以選擇適合的療程，這樣才能安全、健康地找回原屬於自己的「V」字臉。

母親節快樂！肉毒桿菌+拉提讓媽媽回春

作者：健康醫療網／記者張郁梵報導 | 健康醫療網 – 2014年5月7日

（健康醫療網／記者張郁梵報導）

每位媽媽在孩子心中都是最特別、最偉大的女性，為了讓媽媽能有個難忘的母親節，不少子女都用盡心思。日前就有一名五十多歲的婦人，從沒接觸過醫美，但孝順的兒女看媽媽每天為家事操勞，特地帶著媽媽跑去做醫美，讓媽媽美麗回春。

台北醫學大學附設醫院皮膚科暨美容醫學中心柯威志醫師表示，每年到了母親節前夕，前來醫美診所的媽媽們便會明顯增加，有些是自願前來，也有不少是子女帶來的，而進行項目主要還是以「拉提」回春占多數。

傳統回春整型多半以拉皮手術為主，雖然效果良好，但術後疼痛感也較大，也容易有「過度緊緻」的缺點，所幸醫美技術日新月異，新的拉提方式也不斷進步，目前拉提方式則多以非侵入式的電波拉皮、音波拉皮和肉毒桿菌為主。

柯威志醫師說明，和傳統拉皮手術不同，音波拉皮和電波拉皮是以療程方式進行，透過儀器刺激膠原蛋白增生與重組，進而達到緊緻輪廓及撫平紋路的效果。因此，雖然治療進行時間只要一個小時左右，但術後得經過三個月到半年，才會達到緊緻拉提的效果，效果則約可持續兩年左右。

不少來進行醫美回春療程的媽媽們，都會以肉毒桿菌搭配電波或音波拉皮，兩個療程可在一天內完成。柯威志醫師解釋，透過肉毒桿菌注射可撫平臉上的動態性皺紋，像是魚尾紋、眉間皺紋或抬頭紋等，接著再進行拉提，刺激膠原蛋白增生，雙管齊下，效果當然也就更好了。

Is “Silhouette Soft” the new Botox？Cindy Crawford's doctor launches new anti-ageing procedure which uses dissolvable thread to beat wrinkles.

By Bianca London

Published: 15:17 GMT, 29 April 2014 | Updated: 19:55 GMT, 29 April 2014

The new Botox？Dr Jean-Louis Sebagh, a well-known Harley Street doctors, claims his new treatment is 'as big and important as Botox was seven years ago'

Is this goodbye Botox？The £1,200 treatment claims to offer women a redefined face, restored volume and reduced wrinkles by means of a 30-minute treatment, which promises to last up to 18 months

• Dr Sebagh launches Silhouette Soft

• £1,200 treatment claims to redefine face, restore volume and reduce wrinkles

• 30-minute treatment with results lasting up to 18 months

• Uses thread made of polylactic acid, which acts on the deep skin layers

• Naturally stimulates the body so that it produces its own collagen

When it was first revealed that women were paying to have a toxin injected into their faces in an attempt to hold back the march of time, there were howls of derision from the public.

That was more than two decades ago, and even when in 2002 cosmetic Botox received official approval from the US Food and Drug Administration, which evaluates new medical procedures, critics continued to pour scorn on the procedure.

But in recent years, legions of British women have taken up the habit - and celebrities such as Simon Cowell and Kim Kardashian have even tried it out - making it one of the most popular anti-ageing procedures of the decade.

However, while A-listers have been banishing wrinkles with Botox, one of their favourite cosmetic doctors has been quietly championing the next big thing.

Dr Jean-Louis Sebagh is an acclaimed Harley Street doctors who treats and has developed a range of topical creams with supermodel Cindy Crawford.

He says his new treatment is “as big and important as Botox was seven years ago.”

Dr Sebagh, whose clinics in Paris and London's Wimpole Street are packed with the beautiful and the very rich (many fly in to see him the way most of us would pop to the shops), has been offering the treatment for 14 months.

On his website, he describes the £1,200 treatment as a 'technological innovation offering women what no treatment has ever provided in such a simple way: a redefined face, restored volume and reduced wrinkles by means of a 30-minute treatment at their doctor’s, for a result lasting up to 18 months.'

During the procedure, thread made of polylactic acid is drawn through the skin after injections of local anesthetic.

Dr Sebagh says that he uses the thread to give a tailor-made result, lifting specific parts of the face.

This acid is completely biodegradable and acts on the deeper layers of the skin and naturally stimulates the body so that it produces its own collagen.

He claims this action, which continues over time, helps increase the volume of saggy areas and restore shapeliness to the face gradually and naturally.

Speaking to ES magazine about the procedure, he said: 'It's a thread that dissolves completely after 18 months, and it has an immediate lift and lasting regenerative effect, all along the thread.

'It really looks chic,' he said of the 30-minute treatment. 'It restores fat to the right place, with the right tension. It provides volume, but not too much. Not like all these weird faces we see puffed up like balloons.'

'I have used Silhouette Soft thread on ten women today, starting in the morning with a queen of one of the Middle Eastern countries,' he revealed.

Don't fancy having your face threaded or going back for top-ups every six months？Another hot new anti-ageing treatment is being offered by Dr Yannis Alexandrides of 111 Harley St.

How does it work？Dr Sebagh uses the thread to give a tailor-made result, lifting specific parts of the face. The thread, which is drawn through the skin after injections of local anesthetic, is made of polylactic acid.

He swears by the Thermafrax lift, which doesn’t penetrate skin.

It’s a tighten, tone and resurface treatment that combines Thermage technology (Gwyneth Paltrow's favourite) and Fraxel resurfacing to provide what's described as the 'ultimate non-surgical face-lift'.

'It’s a one-off treatment that targets surface skin condition and also deeper layers of skin for a tight, youthful result,' says Dr Alexandrides.

'A surgical facelift requires two weeks minimum recovery time, and only combats sagging, aged skin.

The ThermaFrax Lift targets both the sagging, and improves skin texture with results that last up to 10 years.'

（http://www.dailymail.co.uk/femail/article-2615786/The-new-Botox-Cindy-Crawfords-doctor-launches-new-anti-ageing-procedure-uses-dissolvable-thread-beat-wrinkles.html#ixzz30oyDvwWZ）

醫學美容複合式拉皮

作者：李盛雯╱台北報導 | 中時電子報 – 2014年4月28日

中國時報【李盛雯╱台北報導】

凍齡女神徐若瑄與永遠的玉女周慧敏，數十年不變的青春容顏，是許多五六年級女生羨慕的對象。開業醫劉芳玲表示，再怎麼勤於保養，皮膚的膠原蛋白仍免不了流失，漸漸形成深層皺紋、輪廓鬆弛下垂。母親節前，詢問拉皮的女性增加3成。

要改善皮膚老化下垂，複合式拉皮療程比單一拉皮療程明顯且持久，主要包含第一部分的玫瑰線羽毛拉皮和第二部分的光電波拉皮。至於4D埋線拉皮，主要是使用人體可吸收的縫線線材，透過線材進入真皮層後，為皮膚提供一道支撐力做拉提，然後持續刺激皮下膠原蛋白增生，讓皮膚更緊實有彈性。

但針對嚴重下垂老化的皮膚，去年韓國研發的玫瑰線羽毛拉皮，使用更粗長的線材，加上360度定位鉤，強力撐起鬆垮的臉部線條，再搭配較細的線材做細微紋路加強，挽救下垂肌膚。

開業醫林秉鴻指出，線材置入塑形後，一旦熟齡肌膚的膠原增生不夠，都可能讓拉提效果打折。術後加強保濕，輔以非侵入性光電波拉皮，讓細胞受熱後，加速埋入肌膚的線材與皮下真皮層的膠原蛋白進行收縮、增生，增加皮膚厚度，重新恢復彈性，讓臉部線條更緊實。

林秉鴻建議，除了平時保養要加強保濕，也要減少紫外線傷害，才能避免皮膚提早老化下垂。劉芳玲提醒，埋線拉皮是侵入式治療，不建議孕婦、急性濕疹患者或皮膚治療部位有感染的人採用。

自拍不上相？埋線拉皮調整臉頰輪廓線

【中時健康趙欣／台中報導】2014.03.27

智慧型手機加上行動網路普及，自拍打卡幾乎成了最熱門的新潮流，不管在餐廳、景點或是馬路上，隨處可見抬頭仰著手機拍照的動作。就連奧斯卡頒獎典禮上，大咖明星也瘋自拍。不過，有時後不管怎磨修圖，就是無法擺脫肉肉的臉龐，要是想無修圖的隨意自拍美美照片，還是需要仰賴一些幫助，才能調整到最佳狀態。

想要免開刀就達到拉皮效果，埋線拉皮說是目前的美容新風潮，診所張禮財醫師表示，埋線拉皮適合三十到四十五歲的女性，可以明顯改善中臉及下臉的鬆弛問題，就連輪廓線也會跟著調整，出現最上相的V型臉蛋。

埋線拉皮可以使用的線材有很多種，目前會使用心臟外科手術專用的PDO縫線，埋入皮下半年之後就會被自然吸收。埋線拉提的原理是透過線材進入真皮層後，組織受到外來物刺激，持續刺激皮下膠原蛋白生成，讓皮膚因此變得比較緊實、有彈性。

醫師指出，臨床上也遇過二十多歲的女性就來做埋線拉提，由於原本臉部肌膚就很緊實，只有針對局部進行調整；至於五十歲過後的女性因為老化問題比較嚴重，效果會不明顯，持續持間也縮短許多，比較不建議安排埋線拉皮。

埋線拉提要是使用沒有倒勾的線材，就需要一定數量的線才能交織成一定結構，一般來說半臉就需要四十到五十條，不過要是選擇有羽毛倒勾的PDO線，半邊臉只需三到五條就足以產生明顯拉提效果。

線材選擇上除了價位以外，還要考慮皮膚的鬆弛度，如果老化問題比較嚴重，就會建議選擇有倒勾設計的線，才有足夠支撐拉力。埋線拉皮對於木偶紋、嘴角肉跟法令紋都能加以改善，醫師會從夫妻宮附近入針，一路埋到嘴角附近，效果可以支撐一年半到兩年，通常醫師做完半邊臉之後會讓病人比較左右臉的不同，埋完線之後就看得見效果。

對於選擇埋線拉提的女性，記得做完第一天需要冰敷，減少下針處的腫脹狀況，還要切記一個星期內臉部表情不要太大，也不要大笑，盡量不要側睡，以免埋進去的線位置跑掉。只要耐心一點，兩個月後效果會越來越明顯，拍照打卡再也不用靠軟體修修臉，隨時自信PO出美麗照片。

打造完美小V臉別忽視感染風險

作者：台中訊 | 中時電子報 – 2014年3月20日

中國時報【台中訊】

（中時健康╱王宇仁報導）

韓劇《來自星星的你》裡飾演千頌伊的全智賢，最近紅透半邊天，相較於12年前《我的野蠻女友》，除了飄逸的長髮依舊，那輪廓緊實的小V臉以及完美的下巴線條更是一點也沒變。歲月似乎忘了在全智賢身上留下痕跡，這點不僅令許多女性羨慕不已，更有女性朋友大喊想跟外星人譜出「星星戀曲」。

台中星和醫學美容診所院長顏崇文醫師指出，輕熟齡女性想要擺脫鬆下巴，打造緊實小V臉，不一定非要血淋淋動刀削骨。透過3D微絲提拉術，就能輕鬆消除下臉鬆弛，重塑優美的下巴曲線。

微絲提拉術傷口微創，不會產生明顯不對稱的臉型，適合大部分愛美人士。唯需使用衛生署唯一合法認證的治療用可吸收手術縫線，才能享受良好效果，貪小便宜使用來路不明的縫線，當心不僅臉沒變美，恐有感染毀容的風險。

隨年齡增長，臉部容積逐漸流失，肌膚鬆弛就會逐漸顯現，然而一般輕熟齡女性，鬆弛問題較輕微，臉部輪廓不佳是主要的困擾，因此大部分人並不需要冒著危險動刀削骨或是拉皮來打造臉部線條。

近來醫美走向微創、安全、低風險、零復原期的潮流，其中民眾接受度較高的注射與埋線，兩者雖然都有填補、刺激膠原蛋白增生，達到緊實肌膚功效。不過注射效果較立即，但容易體溫高或代謝能力強，提前被人體吸收而失去效果，而埋線效果雖較遲緩，但效果相對維持較穩定，效期也較長，因此日益受到重視。

顏崇文醫師強調，目前埋線所使用的醫療級可吸收手術縫線，主要分為倒勾線以及平滑線。倒勾線的特殊附著結構設計，能與皮下組織產生強大拉力，這是優點，但也是缺點，一旦稍有不慎，埋入位置不正確，臉型就容易不對稱。相較之下，平滑線具有足夠拉力，能讓肌膚緊實，但效果呈現的時間比較晚，可視狀況進行精細調整，不會出現大小臉等窘況。

值得注意的是，醫美診所競爭激烈，部分業者為了降低成本，使用未經衛生署認證的可吸收手術縫線。市面上縫線約有九成不合法。若民眾抱著比價的心態選擇醫美診所，又沒有認明唯一合法認證的縫線，當心無法達到效果，還可能因縫線而感染發炎，發生毀容的悲劇。

顏崇文醫師提醒，3D微絲提拉針對輕熟齡，臉鬆較輕微的人效果較顯著，若熟齡人士，臉皮鬆弛較嚴重，建議改以手術方式改善，效果較佳。至於部分人代謝能力差，無法有效吸收縫線，產生提拉效果，則可諮詢醫師選擇其他方式雕塑臉型。

整形醫師的告白：各式埋線回春拉皮的真相

【中時健康薛雅文／台北報導】2014.03.19

這幾年，如果消費者有留意醫美產業的消息，一定會注意到有一股趨勢正在興起，就是拉皮的選擇多了好多種名詞。早些年的電波拉皮、微波拉皮到最近與各種「線」相關的拉皮方法，一如絲線、拉線、羽毛線、逆齡線、玫瑰線，甚至4D線，到底這些線是真的有效，還是只是業者的噱頭？

埋線如何做到拉皮！？

台灣形體美容整合醫學會理事長詹富盛表示，目前美容醫學界有許多的研究發現，原本應用在手術縫合的手術縫線，具有刺激人體內纖維蛋白、膠原蛋白增生的特性，因此轉而將之應用在肌膚的回春治療，目前以可吸收線為主流，但是不可吸收的Nylon線在韓國也有許多醫師採用。

這些線有的很細，單純埋入真皮或皮下刺激膠原蛋白生長，改善膚質，手法就像中醫常見的埋線刺激穴位一樣。有的線較粗，可以利用切削的方式讓線具有倒勾而能將下垂的表皮、真皮和深部的韌帶重新拉緊，並且利用其刺激膠原蛋白生長的特性，讓皮膚固定在新的位置而能抵抗地心引力，達到拉皮的效果。

但在那麼多的名詞中，其實只是代表了各家廠商推出的商品名，消費者只需要區分一件事，就是它到底是細的平滑線，或是較粗的有勾線？詹富盛理事長說，如果是平滑線，就是以膚質改善為主，緊致效果不如粗的有勾線，在韓國，則是這兩種線併用，以有勾線為拉皮主力，平滑線則用來輔助膚質改善。

台灣醫美窘況以PDS手術專用縫線切割勾線

值得一提的是，目前台灣有取得真正第二類醫材許可證的其實只有平滑線，而且只有一家廠商取得，其他平滑線或任何的有勾線並沒有一家正式取得第二類醫材許可。因此，部份診所為了達到國際同步的技術水準而不得不偷跑，私下引進韓國熱門的線材，卻也觸犯了法規紅線而被檢舉查抄。

而有許可證的線也因為做的是獨家生意而使售價水漲船高，雖說這是自由市場的必然，但也讓台灣的醫美國際競爭力下滑與停頓不前。為了突破這種困境，少數醫師開始自力救濟，選用目前國內具有許可證的手術線材，自行切割成有勾線以避開法規紅線，並且讓醫師在選擇有勾線的長度時能根據客人的需求而客製化，貼近每個人的狀況。

台灣形體美容整合醫學會法務顧問楊惠中律師表示，根據行政院衛生署2013/01/04公告：「美容醫學」一般係指由專業醫師透過醫學技術，如：手術、藥物、醫療器械、生物科技材料等，執行具侵入性或低侵入性醫療技術來改善身體外觀，而非以治療疾病為主要目的。

為了跟上國際醫美技術的腳步，又不能違法偷跑引進國內尚未取得輸入字號的線材，台灣的醫師不得不採自力救濟的方式，就是使用國內已核可的線材，再自行切割符合臨床上線雕拉皮的需要，以求不要落後韓國太多。

對此，每個月固定前往韓國交流研習的詹富盛理事長指出，簡單使用傳統縫合線稍加裁切之後，配合醫師的手法技術，在美容拉皮方面的應用，於韓國醫美界已發光發熱十來年，光是這一點點小小的變化，台灣就輸了韓國一大步。

也許，政府高喊開發國際觀光醫療市場，努力拼經濟的同時，更應積極輔導有意引進韓國新式相關醫美醫材的廠商取得許可證，才能保持台灣醫美的國際競爭力於不敗，並鼓勵國人自行研發相關醫材，以期能扭轉目前我國醫美實力大幅落後於韓國甚多，並且差距還在拉大中的局面。

鍾楚紅年過半百仍凍齡眉毛成青春關鍵

【中時健康王宇仁／台北報導】2014.03.12

日前港星鍾楚紅歡度54歲生日，48歲的好友劉嘉玲送上生日蛋糕為她慶生，並且貼臉合影留念。令人訝異的是，兩人的臉上絲毫看不出歲月的痕跡，不僅皮膚光滑無瑕，眼角、眉宇間也幾乎沒有鬆弛下垂，宛如青春時的模樣，令人羨慕不已。

其實，許多所謂「不老」的明星藝人，他們的外貌之所以能常保年輕，除了歸功於肌膚保養得宜之外，眉毛、眼尾維持豐盈上提，更是視覺年齡較小且看來有精神的關鍵。而眉毛的上提有賴眉毛上提肌與下拉肌間的平衡，愛惟美診所院長劉淳熙醫師指出，保持太陽穴的飽滿，並注射肉毒桿菌素減低下拉肌的作用，都是延緩歲月痕跡的方法，

此外，當前正夯的超音波拉皮對於提眉也有不錯效果，利用聚焦式超音波可深入筋膜層的特性，除了可使真皮層膠原蛋白收縮，還可使筋膜肌肉層更緊實。普遍來說，治療完1至3個月會有眉尾緊實，眼睛放大的效果。

隨著醫美技術發展進步，劉淳熙醫師說，以往讓人望之卻步的拉皮手術也進入了微創時代，利用線材及內視鏡的輔助，一樣可以做到傷口小，但卻有改善鬆弛肌膚，立即提眉的顯著效果。

以埋線拉皮為例，除了之前熱門的可吸收蛋白線PDO外，新式的塑型線，是一種結合不可吸收式的縫線與多顆聚乳酸圓錐體的線材，其中，聚乳酸圓錐體除了可與皮膚組織進行較緊密的結合，還能刺激膠原蛋白再生，藉此增加肌膚彈性。

而埋線拉皮可分為淺層、深層兩種。淺層幾乎無恢復期，但適合輕微鬆弛者；而深層則是利用髮際線後的微小傷口，以針帶線，將塑型線帶入皮下深處，並固定在深層筋膜上，從深層創造向上提拉的效果。劉淳熙醫師表示，手術同時可視下垂情況，做適度的分離，增加拉提的範圍，對中重度鬆弛者來說，是較理想的方法。另外，除了埋線的方法，醫師也會依鬆弛的程度選擇線材的粗細與倒鉤的走向，增加拉提的力量。

至於「內視鏡提眉」則是一種能改善眉宇間老態的方式。劉淳熙醫師解釋，所謂的內視鏡拉皮是自髮際線後不遠處，約開4個各約2公分以內的小傷口，深入內視鏡精細觀察皮下狀況，再徹底剝離鬆弛組織，特別是將眼眶旁，眉骨上的強軔連結加以切斷，再往上定位，效果才較持久。因此，不必過度切除贅皮就能使眉毛上揚，放大眼睛，同時改善泡泡眼、下垂眼。

雖然微創拉皮傷口不大且效果顯著，但台灣整形外科醫學會會員張耀元醫師仍提醒，本身患有如狼瘡、白斑症、牛皮癬等皮膚疾病者，或是有蟹足腫病史的人都不適宜進行此種拉皮手術。此外，若是有長期服用如阿斯匹靈、沃服林等抗凝血藥物的人，都要由專業的醫師進行全面的評估，才決定是否能接受手術。

開運迎新　羽毛線提眉見神采

NOWnews – 2014年2月5日

生活中心／綜合報導

「眼睛」是靈魂之窗，在五官當中也最受人注目，若能擁有一雙水汪汪的大眼睛，無論是觀察周遭變化或在與他人交談時，用眼神眉梢傳達心境與表現情緒，更勝於千言萬語或一堆的肢體動作。因此，隨著年關將近，已有許多人想要藉由醫學美容的輔助，讓自己擁有一雙充滿魅力的電眼。

許多人原本可能擁有一雙漂亮的眼睛，但隨著年紀的增長、工作與生活的壓力、習慣用單眼注視或挑眉，以及用不正確的姿勢斜躺看電視等因素，而讓眼睛外形有所改變。但是，隨著醫療美容科技的進步，透過眼整形手術解決這些問題已非難事。

京硯整形外科診所院長張耀元表示，目前的上眼部的整形手術主要有縫眼皮、割眼皮、羽毛提眉、五爪拉皮手術、短疤拉皮、提眼瞼肌手術(調眼神)等幾種方式；至於需要接受哪一種手術，須由醫師依據個人不同的狀況、年紀、天生條件、臉形比例、自我需求等條件進行評估，並採取不同的處理方式。

張耀元醫師指出，隨著年紀的增長，人的眉毛外側會逐漸下垂，若想改善就得進行提眉手術，除了可以拉提下垂的眉毛之外，也能解決八字眉等惱人的情況。他以羽毛線提眉手術為例說明，手術所置入的材質為美國FDA及台灣衛福部皆核准可置入人體軟組織的產品，並於置入後約一年半即可被人體吸收；施做的時間約為1至1.5個小時，且恢復期僅需約3到5天。

此外，張耀元醫師還表示，有些人會因為眼瞼下垂而導致看起來沒睡飽、精神不好。眼皮內有一條提眼瞼肌，當它收縮時，會讓眼睛張開；所以，當提眼瞼肌的功能不佳時，將導致眼瞼張開程度不足，會造成瞇瞇眼的狀況，這時就必需透過提眼瞼肌手術加以改善。

針對提眼瞼肌手術，張耀元醫師解釋，傳統的提眼瞼肌手術，是經由雙眼皮折痕的傷口來進行提眼瞼肌的矯正，且因必須調整至兩眼對稱，故較其它的眼整型手術來的耗時；然而，目前市場上流行的無痕提眼瞼肌手術，由於是經由眼皮裡側將鬆弛的提眼瞼肌重新拉緊，故術後恢復期僅約一週，且因為沒有傷口，無須拆線，不會在眼皮上留下疤痕。

現在已有越來越多人想藉由整形從「瞇瞇眼」變成動人的明眸，但張耀元醫師提醒民眾，不論是進行哪一種眼整形手術，務必在事前向專業醫師詳細諮詢，並依據醫師的評估進行選擇，這樣才能讓自己在新的一年擁有一雙迷人的電眼。

埋線拉皮藏危機？女業務員變歪嘴 原來是法令紋一邊消失 另一邊還在

TVBS – 2014年1月20日

台中一名女業務，因為認為自己的法令紋很深，到醫美診所接受目前很夯的埋線拉皮，結果術後卻發現笑容怪怪的，原來是法令紋一邊消失，另一邊還在，看起來像嘴巴歪一邊，後悔不已。

醫師建議，這種手術一定要選有經驗的整形醫師操刀，而且醫師要夠瞭解皮下組織結構，才比較不會失敗。

微笑是最好的化妝品，但是如果笑起來有法令紋，可能讓追求完美的女性很困擾，除了可以注射肉毒桿菌素或玻尿酸或微晶瓷來撫平，還有一種方法4D埋線拉皮。現代整形院長王鳴祥：「埋線拉提現在是一般最流行的，一種治療法令紋做V臉的方式。」

這種韓國新一代無痕拉皮術，是利用極細小的針頭，把人體可吸收的倒勾線帶入皮膚組織，勾住皮膚的筋膜層，達到向上拉提作用。

不過台中一名35歲的女業務，日前到醫美診所埋線拉皮，結果竟然造成笑起來嘴巴歪一邊，事後再度上門詢問，醫師竟然推說是她的體質問題，她只好轉向其他整形醫師求診，才發現有一側的線放錯位置。現代整形院長王鳴祥：「應該是慢慢會復原，當然也有可能整個顏面神經，手術整個把它刺斷。」

根據瞭解，這種不動刀的複合式微整形，醫師必須充份了解臉部軟組織的分佈和法令紋的成因，否則很有可能造成失誤。而手術的失敗，害得這名女業務現在不太敢笑，嚴重影響業績，提醒為了愛美的女性最好三思，以免付出慘痛代價。

醫美又出包！女子埋線拉皮　法令紋一邊消失 一邊還在 竟成歪嘴妹

優活健康網 – 2014年1月20日

（優活健康網記者陳靜梅／綜合報導）

醫美又出包！埋線拉皮暗藏危機！

台中一名35歲女業務員因法令紋很深，讓愛美的她相當困擾，有次到一家醫美診所求診，被醫師說服做埋線拉皮，醫師聲稱此方法可以讓法令紋變淺，沒想到微整型失敗，反倒成了歪嘴妹。

真的好衰！除法令紋不成反而歪嘴

女業務員表示，她原先以為自己終於可以有一口燦爛的笑容，不再受法令紋之苦，沒想到術後發現法令紋一邊消失、一邊還在，笑起來乍看之下，就像是臉歪了一邊，實在是欲哭無淚；發現手術失敗後，她回去詢問醫師，醫師竟推託是體質問題，也不設法幫她補救，她只好向其它整型外科醫師求診。

醫師建議愛美女性，應慎選專業的整型外科醫師，才不會愛美不成、反遭致不好的效果，白花冤枉錢。

想回春埋線拉皮後嘴歪原來是法令紋一邊消失另一邊仍在

作者：記者趙容萱╱台中報導 | 聯合新聞網 – 2014年1月20日

林姓女業務因法令紋明顯，到醫美診所埋線拉皮，竟造成嘴歪。醫師建議，為追求年輕嘗試微整形的民眾，一定要慎選整形外科醫師，較清楚皮下組織結構，才不會造成反效果。

林姓女業務員35歲，她表示自己法令紋很深，外表看起來比實際年齡老了5歲，不利業務推廣，因此到醫美診所埋線拉皮。術後發現笑容怪怪的，原來是法令紋一邊消失，另一邊仍在，看起來成了嘴歪。

林女說，她原本要開心迎接回春的生活，結果竟變得不太敢笑，講話就習慣遮嘴巴，被客人誤會，嚴重影響業績。她事後詢問拉皮的醫師，對方竟推說是體質問題，她不相信，轉向其他整形醫師求診。

醫師賴炳文說，埋線拉皮是利用可為人體吸收的倒勾線，勾住皮膚的筋膜層，達到向上拉提作用，不少愛美人士靠它回春，但皮下組織結構複雜，若技術不成熟放錯位置或角度，易鬆脫造成嘴歪現象。

醫師詹子昇說，埋線拉皮年紀愈輕皮膚修復能力愈好，埋的針數較少，同時還要考量埋線位置、方向與深度，最好找有經驗的醫師。埋線後，避免在6小時內運動、碰水和按摩。

打造逆齡美顏　切勿輕信廣告宣傳

NOWnews – 2014年1月3日

記者林亞樺／綜合報導

隨著歲末年終的到來，各種節日的慶祝活動也跟著接踵而至，許多人都開始安排各種聚會，與親朋好友一起歡聚聖誕或跨年時光；除了關心彼此的近況之外，不少人難免要回憶年輕歲月的美好時光，並感嘆歲月催人老。然而，隨著醫療美容技術的進步，目前市面上早已有多種療程能夠滿足愛美族回春的需求，甚至可按個人的需求，針對個別部位進行處理。

以回春療程中主要需求的拉皮為例，整型醫師謝佳憲醫師表示，隨著年齡的增加及新陳代謝逐漸緩慢，人體的皮膚容易變薄；同時，由於皮膚的膠原蛋白持續流失，導致皮膚與皮下組織、肌肉無法緊密附著，就會造成臉部下垂、嘴邊肉、法令紋等惱人的生理現象。

謝佳憲醫師指出，在早期，拉皮只能選擇以傳統手術或內視鏡方式來進行，但這兩種方式不僅需要全身麻醉，且恢復時間較長、疼痛感劇烈；後來，雖然陸續有電波拉皮、肉毒桿菌注射等方法出現，但在滿足患者需求的程度上都不如傳統拉皮與內視鏡拉皮。除此之外，最近市場上還引進一種「蜜拉克拉提」，標榜可兼顧拉提、緊實及平滑的需求，並受到不少愛美族的青睞。

針對蜜拉克拉提，謝佳憲醫師解釋，此種拉皮是先由醫師對於患者皮膚老化的狀況進行評估，接著再決定可被人體吸收的線材數量，並將其置入欲處理的部位；經由回填臉頰凹陷的部位，除了一般臉部鬆弛下垂、法令紋、嘴邊肉等問題能獲得解決，還可藉由刺激肌膚膠原蛋白的增生，以滿足緊實的需求。

謝佳憲醫師進一步說明，相較於傳統的拉皮手術，蜜拉克拉提同樣可作用於較深的筋膜層；另外，此種拉皮的方式僅針對局部麻醉即可進行，每次的手術時間約為40至50分鐘。

但謝佳憲醫師還是特別提醒愛美族，目前市面上的回春療程琳瑯滿目，無論是選擇哪一種回春的方式，切勿隨便輕信不實的廣告宣傳，一定要先向合格的專科醫師進行諮詢、溝通和評估自己的狀況，並在確認安全的情況下，由擁有專業資格或證照的人員進行療程，才不會衍生醫療糾紛，打造出屬於自己的緊緻肌膚。