Abstract：Objective This study aims to investigate the clinical efficacy of targeted injection of stromal vascular fraction (SVF) gel based on the anatomy of the periorbital fat compartment in the treatment of orbital aging with soft tissue loss. Methods A retrospective cohort study was conducted on 46 patients with periorbital rejuvenation in the Department of Plastic Surgery of the First Affiliated Hospital of Bengbu Medical College from January 2021 to June 2022. The patients included 43 females and 3 males, with age of 27-47 (35.3±3.5) years and body mass index (BMI) of 18.6-24.4 (20.5±1.6) kg/m2. Periorbital aging was rated as grade 1 in five patients, grade 2 in 17 patients, and grade 3 in 24 patients. Coleman fat and SVF gel were prepared by manual liposuction at low negative pressure in the inner thigh or lower abdomen. According to the different injection materials and methods, the patients were divided into two groups: the observation group (25 patients) and the control group (21 patients). The periorbital depression was filled with fine targeted injection based on the anatomy of the periorbital fat compartment, and that of the control group was filled with Coleman fat. Baseline data such as sex, age, BMI, periorbital aging grade, operation success rate, and postoperative complications were compared between the two groups. The three-dimensional(3D) scanning images of the patient's face before, immediately after, and 3 months after the operation were best fitted by 3D laser scanner. Changes in periorbital volume were analyzed by color scale map. The linear distance between the lacrimal groove point and the periorbital sulcus depression in 38 patients without secondary filling within 1 month after surgery was calculated. The satisfaction of patients was evaluated using a questionnaire 3 months after the operation. Results No significant differences in sex, aging grade, age, and BMI were found between the two groups (all P values>0.05). All the 46 patients completed the injection and filling treatment, and postoperative complications such as infection, hematoma, fat embolism, induration, and unequal complications were not recorded. Eight patients received secondary filling injection within 1 month after the first injection according to the patient's request and the surgeon's evaluation. Compared with the preoperative 3D deviation color scale map, the periorbital injection area of all patients increased in volume 3 months after the operation. The linear distance showed that the depression of the upper and lower eyelids was significantly improved in the observation group and the control group who received secondary injection 3 months after the operation. However, the improvement values at 3 months after the operation were lower than those immediately after the operation, and the differences were statistically significant (t=18.76, 20.02, 9.94, 23.63, all P values<0.001). At 3 months after the surgery, the improvement value of orbital eyelid sulcus depression in the observation group (12 patients) was 4.90±0.41 mm, which was higher than that in the control group (10 patients) ([3.81±0.28 mm]). The improvement value of lacrimal sulcus point depression in the observation group (18 patients) was 2.21±0.22 mm, which was higher than that in the control group (14 patients) ([1.81±0.22 mm]), and the differences were statistically significant (t=7.17, 4.99, all P values <0.001). The satisfaction of the observation group was higher than that of the observation group at 3 months after the surgery, and the difference was not statistically significant between the two groups (Z=1.30, P=0.194). Conclusion Based on the anatomy of periorbital fat compartment, fine targeted injection of SVF gel can improve periorbital depression and skin quality better than the traditional Coleman fat injection and has fewer postoperative complications and higher patient satisfaction; hence, the proposed method has higher clinical value in periorbital rejuvenation.
孙晓涵, 徐静, 张硕, 贾梦娜, 赵书含, 宋培军. 精细化靶向注射自体脂肪干细胞基质胶治疗眶区轻中度老化的效果观察[J]. 中华解剖与临床杂志, 2023, 28(11): 723-730.
Sun Xiaohan, Xu Jing, Zhang Shuo, Jia Mengna, Zhao Shuhan, Song Peijun. Efficacy of targeted injection of stromal vascular fraction gel in the treatment of mild to moderate periorbital aging. Chinese Journal of Anatomy and Clinics, 2023, 28(11): 723-730.
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2023, Vol. 28 
