Kukwezera Nkhope Yakuya Kwambiri ndi Njira Zothandizira Kutsitsimutsa Nkhope Yapamwamba, Yapakati, ndi Yapansi

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Maola a 3 ndi mphindi 30 zavidiyo yogwira ntchito. 2018.

MUDZAKHALA KUKHALA KUKHALA KUKHALA KULIMBIKITSA KULIMBIKITSA KULIMBIKITSA (FAST SPEED) MUTHA KULIPIRA

ndi Andrew A. Jacono, MD, FACS

Muvidiyoyi, Andrew A. Jacono, MD, FACS, dokotala wamkulu wa opaleshoni ya nkhope ya pulasitiki yodziwika bwino pa okalamba okalamba, amakweza nkhope yakuya yomwe wapanga, ndi njira zowonjezera kuti atsitsimutse kumtunda, pakati, ndi pansi pa magawo atatu a nkhope. Luso la opareshoni yokonzanso nkhope yagona pakusankha njira zophatikizira bwino. Njira yonseyi yotsitsimutsa nkhope imaphatikizapo kukweza kwapambuyo kwakanthawi kochepa, kusungitsa minofu kumtunda kwa blepharoplasty, blepharoplasty yocheperako yocheperako yokhala ndi orbitomalar ligament kutulutsidwa ndi orbital mafuta transposition, ndi kusinthidwa milomo. Mfundo zotsogola muukadaulo wake ndikuyikanso mafuta aku nkhope ndi zikope kuti awonekere nkhope yokalamba ndikusunga minofu yofewa. Kuphatikizika kwa njira zimenezi—kukwezeka kwa kachisi, nkhomaliro, ndi masaya; kuphatikiza kwa chivundikiro-cheek mphambano; ndi kufupikitsa mlomo wapamwamba-kumatanthauziranso momwe nkhope yowongoka komanso yopingasa, kutembenuza rectangle wokalamba kukhala nkhope yooneka ngati mtima ya unyamata. Owonerera adzapindula ndi momwe Dr. Jacono akuwonetsera luso lake mwaluso potengera chidziwitso chake chochuluka cha chibadwa.

Mlanduwu uli ndi kuwunika bwino kwa mawonekedwe a wodwala asanachite opaleshoni komanso zolinga za opaleshoni. Njira yapang'onopang'ono ikuwonetsedwa kuchokera pakulowetsedwa kwa anesthesia wamba mpaka kutseka. Pa nthawi yonse yotambasula yakuya ya ndege, Dr. Jacono akufotokoza njira yopita ku ndege yakuya; kumasulidwa kwa zygomatic, masseteric, ndi mandibular cutaneous ligaments; kukwera kwa malar fat pad kuchokera ku zygomaticus musculature; ndi vertical vectoring chakuya chakuya kuti chiwongolere chapakati. Pakati pa dissection yapakati, kuyandikira kwa danga la buccal kumawonetsedwa kuti muwonetsetse mafuta a buccal pad ndikuchepetsa ngati pakufunika. Mbali yokweza khosi ya opaleshoniyo ikuwonetseratu njira ya Dr. Jacono yotambasulira ndege yakuya m'khosi, kukweza minofu yambiri ya platysma yotsika kwambiri kuchokera ku minofu ya sternocleidomastoid komanso pakati. Ndi platysma myotomy, chotchinga ichi chimasinthidwa kukhala choponyera cha platysma, chothandizira chithokomiro cha submandibular ndikupanga mawonekedwe omveka a nsagwada. Kuti apititse patsogolo khosi lapakati, njira yake yotsegulira khosi ikufotokozedwa, kuphatikizapo kukwezedwa kwapakati pakatikati, interplatysmal ndi subplatysmal mafuta kuchotsa, digastric chithandizo, ndi kuyimitsidwa kwa hyoid fascia kwa midline platysma pa corset platysmaplasty.

Njira yonseyi yotsitsimutsa nkhope ndi khosi imaphatikizapo:

• Kukweza kumaso kwa ndege yakuya
• Kukweza kwa endoscopic lateral temporal lift
• Kuteteza minofu kumtunda kwa blepharoplasty
• Kuwonjezedwa kwa submuscular lower blepharoplasty yokhala ndi orbitomalar ligament kumasulidwa ndi orbital mafuta transposition.
• Kukweza milomo yosinthidwa
• Kukweza khosi, ndikuwunikira njira ya Dr. Jacono yokulitsa kufalikira kwa ndege pakhosi.