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下睑老化的实质是组织的萎缩和松弛，临床上常将下睑老化表现分成四型：（１）下睑皮肤松弛；（２）眼轮匝肌肥厚；（３）眶内脂肪过多而致的脂肪膨出，或眶膈松弛致使脂肪疝出；（４）混合型。下睑成形术的术式较多，本文就下睑老化四个类型应采取的不同术式作了较详细的分析，提出皮肤松弛型可仅切除多余的皮肤。眼轮匝肌肥厚型可切除部分眼轮匝肌，并同时做眼轮匝肌内外眦悬吊术，以减轻下睑低张。而对眶内脂肪疝出或膨出的患者，大多不切除脂肪，只有当眶膈缩紧术仍无法改变下睑袋外观时，才采取切除疝出的眶膈脂肪的术式。同时还强调了颞部除皱术和眼轮匝肌下脂肪垫在下睑成形中所起的辅助作用。
The essence of the lower eyelid aging is tissue atrophy and relaxation, the clinical performance of the lower eyelid aging is often divided into four types: (1) lower eyelid skin relaxation; (2) orbicularis muscle hypertrophy; (3) orbital fat and Fat caused by bulging, or loose septal diaphragm fat hernia; (4) mixed type. Blepharoplasty surgery more, the paper on the four types of lower eyelid aging should be taken in different surgical procedures made a more detailed analysis of the proposed loose skin type can only remove excess skin. Orbiculare muscle hypertrophy resectable part of the orbicularis oculi muscle, and at the same time do the orbicularis muscle suspension, in order to reduce the lower eyelid hypotension. Of orbital fat hernia or bulging patients, most do not remove the fat, only when the orbital phrenic shrinkage surgery still can not change the appearance of the lower eyelid bag, only to remove the hernia of the orbital fat. At the same time, it also emphasized the auxiliary role of temporal wrinkle removal and suboccipital fat pad in the formation of lower eyelids.