【 文献重点摘要 】
 

Background: Lower face aesthetic contouring is in high demand among Asians with wide and short faces desiring a slim lower face. For this purpose invasive mandible angle reduction and genioplasty are complex procedures with significant risks and downtime. Non-invasive botulinum toxin A injection into bilateral masseters − while popular for lower face contouring − does not address facial length deficiency in wide and short faces. Autologous chin fat grafting is a simple minimally-invasive technique for facial lengthening.

Objectives: We present our experience pairing chin fat grafting and masseteric botulinum toxin injection for effective lower face contouring.

Methods: Thirteen consecutive patients with relatively wide and short faces underwent chin fat grafting and 1 to 3 serial masseteric botulinum toxin A injections. Mean follow up after final intervention was 20 months (range, 6 months to 3 years).

Results: The postoperative mean ratio of bigonial distance to total facial height improved from 0.599 to 0.569 (P< .01), closer to the ideal ratio of 0.561. The mean ratio of upper lip length to lower lip and chin length improved from 0.611 to 0.560 (P< .01), nearing the ideal 0.542. Postoperative lateral profile in all was ideal. There were no complications at follow up. Results were durable at latest follow up and most were satisfied with their final appearance.

Conclusions: Combined tridimensional chin fat grafting and botulinum toxin masseteric injection is an effective, simple, fast, inexpensive, safe, and minimally-invasive strategy for aesthetic lower face contouring of short and wide faces, with short downtime, long-lasting results, and high patient satisfaction.

背景：亚洲人对下脸美学轮廓的需求很高，因为宽脸和短脸都想要苗条的下脸。为此，侵入性下颌角复位和颧骨成形术是非常复杂的过程，有很大的风险和停机时间。非侵入性肉毒杆菌毒素A注射到双侧咬肌−虽然在下面部轮廓中很受欢迎−，但不能解决宽脸和短脸的面部长度不足问题。自体下巴脂肪移植是一种简单、微创的面部拉长技术。

目的：我们介绍我们的经验，配对下巴脂肪移植和咀嚼肌肉毒毒素注射，以有效的下面部轮廓。

方法：对13例面部较宽、较短的患者进行面颊脂肪移植及1~3次咀嚼肌A型肉毒毒素注射。最后干预后平均随访20个月(6个月~3年)。

结果：术后平均双面距与面高的比值由0.599提高到0.569(P< .01)，接近理想的0.561。平均上、下唇长比由0.611提高到0.560(P< .01)，接近理想的0.542。术后侧位均较理想。随访时无并发症发生。在最近的随访中，结果是持久的，大多数人对他们的最终外观感到满意。

结论：三维下巴脂肪移植联合肉毒毒素咀嚼肌注射是一种简单、快速、廉价、安全、微创的面部美容方法，具有手术时间短、效果持久、患者满意度高等优点。