臀部软组织解剖及脂肪塑形安全层次探讨
Anatomy of the gluteal region and its implication in liposculpture
孟湉 1斯楼斌 1龙飞 1戚征 1王阳1
作者信息
- 1. 中国医学科学院北京协和医院整形美容外科 100730
- 折叠
摘要
目的 研究臀部各组织层次的形态学特点和重要解剖结构,探讨臀部脂肪塑形推荐层次及安全区域.方法 对14具成人尸体28侧臀部标本进行解剖,其中新鲜尸体8具16侧,甲醛溶液保存的尸体6具12侧,男性2例,平均年龄49岁,女性12例,年龄23～72岁,中位年龄46岁.对尸体臀部进行逐层解剖,观察其各组织层次形态学特点,浅、深筋膜系统、脂肪组织分布特点以及臀部大血管神经与组织层次的关系.结果 臀部软组织层次由浅入深为皮肤、皮下脂肪、浅筋膜系统、深筋膜系统、肌肉及其筋膜室.皮下脂肪分浅、深2层分布;浅筋膜系统发达致密,呈层状结构;深筋膜菲薄,呈肌外膜性筋膜特点;臀部存在一危险三角区,即以第一骶椎为顶点、两侧臀下皱襞内侧2/3为底点相连的三角形区域的深层肌肉,重要血管神经位于此区.结论 针对中国人臀部的形态特点,脂肪塑形时主要抽吸髂腰部、大腿后外侧脂肪,可显著增加臀部相对突度和饱满度;臀部丰满者可适当抽吸深层脂肪;应轻柔纵向抽吸,以减少对浅筋膜系统的损伤.臀部脂肪注射存在较高风险,推荐使用内径3 mm以上的钝头针管,平行于臀大肌纤维走向,边退针边扇形均匀注射.将大部分脂肪注射于皮下脂肪层即可获得满意效果,避免向危险区域深层注射移植物.
Abstract
Objective To study the morphological characteristics and important anatomical structures of each soft tissue layer of gluteal region, and discuss the recommended levels and safe areas for liposculpture in this region. Methods Twenty-eight specimens of unilateral buttocks from 14 adult cadavers, including 16 specimens of unilateral buttocks from 8 fresh cadavers and 12 specimens from 6 formaldehyde fixed cadavers were dissected. Among the cadavers, there were 2 males with an average age of 49 years, and 12 females from 23 to 72 years old, median age 46 years. Through anatomy study of soft tissue layers of gluteal region, the morphological features of each layer were observed and documented, and the characteristics of fascia system and adipose tissue, as well as the relationship between the blood vessels and nerves with corresponding layers. Results The layers of the gluteal region that range from superficial to deep are skin, subcutaneous fat, superficial fascia system, deep fascia system, muscle and fascia compartments. Subcutaneous fat is distributed in superficial and deep layers;the superficial fascia system is well developed and dense with a layered structure; the deep fascia is thin with the characteristic of epimysium. There is a danger zone for deep fat graft in the gluteal region, with its apex at the first sacral vertebra, and its base goes along the gluteal fold, compromising the thighs' medial two-thirds. Nearly all important blood vessels and nerves of gluteal region are located in deep layer of this danger zone. Conclusions Based on the characteristics of buttocks of Chinese people, liposuction is mainly performed in the iliolumbar region and posterolateral thigh, which can significantly increase the relative height and fullness of buttocks. For full buttocks, deep fat can be sucked appropriately, which should be longitudinal and gentle to reduce the damage to the superficial fascial system. There is a high risk for fat graft in the buttock. It is recommended to use a blunt needle with an inner diameter of more than 3 mm parallel to the fiber orientation of gluteus maximus for uniform fan-shaped injection with needle withdrawal. Satisfactory result can be obtained by injecting most fat into the subcutaneous adipose layer. Deep injection of grafts into dangerzoneis forbidden.
关键词
臀部/解剖学,局部/脂肪抽吸/脂肪颗粒注射移植术Key words
Gluteal region/Anatomy,regional/Suction lipectomy/Fat granule injection grafting引用本文复制引用
出版年
2019
NETL
NSTL
维普
万方数据