
[Concepts of Soft Tissue Layers & Spaces]
face lifting¿¡ ´ëÇØ¼ ¾Ë¾Æº¸±â Àü¿¡ ¾È¸éÀÇ ÇØºÎÇÐÀûÀÎ ÀÌÇØ´Â ÇʼöÀûÀÌ´Ù.
À̿Ͱ°Àº º¹ÀâÇÑ anatomy¸¦ ÀÌÇØÇϱ⠾ռ¼ ¾È¸éÀÇ ±âº» ±¸Á¶¸¦ ÀÌÇØÇÏ´Â °ÍÀÌ µµ¿òÀÌ µÈ´Ù.
¾È¸é°ú scalp´Â ¸î °ãÀÇ layer·Î ±¸¼ºµÇ¾î Àִµ¥, ÀÌ´Â ±¸Ã¼ÀûÀ¸·Î ´Ù¼¸ °¡Áö ±âº» layer·Î ±¸¼ºµÇ¾î ÀÖ´Ù.
(1) Skin
(2) Subcutaneous layer
(3) Musculoaponeurotic layer (SMAS)
(4) Loose areolar tissue (ie, spaces and retaining ligaments)
(5) Fixed periosteum and deep fascia
ÀÌÁß ¿ì¸®°¡ °¡Àå ÁÖ¸ñÇÏ¿©¾ß ÇÒ ºÎºÐÀº '(3) Musculoaponeurotic layer'ÀÌ´Ù.
¡®Musculoaponeurotic layer (layer 3)¡¯´Â¡® subQ layer (layer 2)¡¯ÀÇ retinacular cutis fibers·Î ¡®skin (layer 1)¡¯±îÁö ºÙ¾îÀÖ´Ù. Musculoaponeurotic layer´Â upper face¿¡¼ scalp·Î ³Ñ¾î°¡¸é¼ ¡®galea' ¿Í flat muscleÀÎ ¡¯occipitofrontalis¡®·Î ÇÕÃÄÁø´Ù.
¶ÇÇÑ ¸ñÀ¸·Î ³»·Á°¡¸é¼´Â platysma muscle ·Î ÇÕÃÄÁø´Ù.
(1), (2), (3) ÀÌ ¼¼ °¡Áö layer°¡ ¡®functional unit¡¯¸¦ Çü¼ºÇϴµ¥, flap surgery µî¿¡¼ ÇϳªÀÇ ´ÜÀ§·Î ¹Ú¸®µÇ°í À̽ĵȴÙ. º¸Åë ¡®(3) Musculoaponeurotic layer¡¯¸¦ ¡®Superficial MusculoAponeurotic System (SMAS)'¶ó°í Ç¥ÇöÇÑ´Ù. SMAS´Â fascia¿Í ¿©·¯ °¡Áö facial intrinsic muscle µéÀ» Æ÷ÇÔÇϰí ÀÖ´Ù.
Functional unit (1+2+3)°¡ periosteum À§¿¡¼ ¿òÁ÷ÀÏ ¼ö ÀÖ´Â °ÍÀº, '(4) loose areolar tissue'°¡ Àֱ⠶§¹®ÀÌ´Ù. ÀÌ ³× ¹øÂ° layer´Â µÎ °¡Áö »ó¹ÝµÈ Áß¿äÇÑ ±â´ÉÀÌ ÀÖ´Ù. ù°´Â facial bone¿¡ soft tissue°¡ Àß ºÙ¾î ÀÖÀ» ¼ö ÀÖ°Ô ÇÑ´Ù. µÑ°´Â boneÀ§¿¡¼ soft tissue µé ¿òÁ÷ÀÏ ¼ö ÀÖ´Â, Áï gliding movement°¡ °¡´ÉÇÏ´Ù. ÇǺΠ³ëÈ·Î aging laxity°¡ ½ÉÇØÁö¸é ÀÌ gliding planeÀÇ °ø°£ÀÌ ³Ð¾îÁö°Ô µÇ´Â ÀÓ»óÀûÀÎ Àǹ̰¡ ÀÖ´Ù. Facial nerve µé°ú vessel µéÀÌ (4)¹ø layer ¹ÛÀ¸·Î ´Ù´Ï´Âµ¥, layer³»¸¦ Åë°úÇÏÁö´Â ¾Ê´Â´Ù.