![](https://2.bp.blogspot.com/-KTNJj1dt6vY/Wh5Uepa0TNI/AAAAAAAAaY0/9Z1bK63pWxEw8UvbkFgMUVsxAT4QtoGswCLcBGAs/s1600/3D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8sculptra%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AE%25E7%25AB%25A5%25E9%25A1%258F%25E9%2587%259D%25E6%2589%2593%25E5%25A4%259A%25E5%25B0%2591CC%25E8%25B2%25BB%25E7%2594%25A8%25E5%25A4%259A%25E5%25B0%2591%25E9%258C%25A2%25E5%2583%25B9%25E6%25A0%25BC%25E7%258E%25BB%25E5%25B0%25BF%25E9%2585%25B8true-lift%25E6%2596%25B0%25E7%25AB%25B9%25E6%259E%2597%25E4%25BA%25AE.jpg)
「看著自己在相片裡,赫然發現自己的下顎線鬆了!側臉完全不能見人。」
「我發現自己低頭的時候,肉全都往下墜!意識到自己真的皮鬆了!」
除了輪廓塑形、雷射治療,抗老、拉提在美容醫學領域,更受矚目,因為「老化」是每個人必經過程,誰也無法躲避。不管在東西方國家,拉提、整體視覺年輕化相關治療,如何利用不同的注射物、打在哪些位置,讓本來鬆弛的線條、臉蛋,回到緊緻、年輕的狀態,經常在各大演講、學術會議上被拿出來探討,也是許多醫師相互交流、切磋的議題。
大家都知曉,過了25歲,膠原蛋白流失加劇,實際上老化不只是此,包含深層的臉部骨架萎縮流失,筋膜層鬆弛,軟組織流失、往下位移,及臉部韌帶鬆弛。在抗老治療領域頗有心得的林亮辰醫師,受邀分享臉部拉提注射心得。針對臉部的老化、注射時的治療技巧、重點,與現場的醫師交流、切磋。
![](https://3.bp.blogspot.com/-7iyfsyWKv4M/Wgrtx_DgWjI/AAAAAAAAaC8/KNOaBK98KZUID0NaKyj7ElojwX1JFIZnwCLcBGAs/s1600/3D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8sculptra%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AE%25E7%25AB%25A5%25E9%25A1%258F%25E9%2587%259D%25E6%2589%2593%25E5%25A4%259A%25E5%25B0%2591CC%25E8%25B2%25BB%25E7%2594%25A8%25E5%25A4%259A%25E5%25B0%2591%25E9%258C%25A2%25E5%2583%25B9%25E6%25A0%25BC%25E7%258E%25BB%25E5%25B0%25BF%25E9%2585%25B8true-lift%25E6%2596%25B0%25E7%25AB%25B9%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB14.jpg)
輪廓線下墜的肇因 真性韌帶下垂
![](https://2.bp.blogspot.com/-Es6zWr4NT_A/WglnK6SGm6I/AAAAAAAAACM/OyPkt1wtnYEvMC6UMYC07G0sQkie8tcOQCEwYBhgL/s1600/3D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8sculptra%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AE%25E7%25AB%25A5%25E9%25A1%258F%25E9%2587%259D%25E6%2589%2593%25E5%25A4%259A%25E5%25B0%2591CC%25E8%25B2%25BB%25E7%2594%25A8%25E5%25A4%259A%25E5%25B0%2591%25E9%258C%25A2%25E5%2583%25B9%25E6%25A0%25BC%25E6%2596%25B0%25E7%25AB%25B9%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB4.jpg)
真性韌帶是由骨膜垂直延伸到皮膚,維繫皮膚、皮下組織與骨膜牢固束縛,短而結實。不過,老化會讓韌帶開始傾斜、下墜(如上圖所示),而這正引起臉部鬆弛的主要成因。也就是一般人認知的下垂,表現上就是組織下滑、輪廓線下墜。
![](https://3.bp.blogspot.com/-uEC1ThGQVFw/WgloqZF0V_I/AAAAAAAAAC8/T9EYikaN9rY1oj-d0WY7wq1htaLrjtHkQCLcBGAs/s1600/3D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8sculptra%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AE%25E7%25AB%25A5%25E9%25A1%258F%25E9%2587%259D%25E6%2589%2593%25E5%25A4%259A%25E5%25B0%2591CC%25E8%25B2%25BB%25E7%2594%25A8%25E5%25A4%259A%25E5%25B0%2591%25E9%258C%25A2%25E5%2583%25B9%25E6%25A0%25BC%25E7%258E%25BB%25E5%25B0%25BF%25E9%2585%25B8true%2Blift%25E6%2596%25B0%25E7%25AB%25B9%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB15.jpg)
除了會覺得自己臉上的陰影、凹陷變多了,也會覺得兩頰的肉因為往下掉,掛在下緣,臉型從緊緻的V臉,變成了U臉;另外一個指標,大家可以把鏡子平放在桌上,低頭照,會發現自己眼睛下、臉頰的肉都一起往地下墜。
![](https://3.bp.blogspot.com/-mWCaNpgh73I/Wh4dEM_J1SI/AAAAAAAAaYQ/UPKefSPHtr8ryXYujlCgv-v0uBIH6D_hQCLcBGAs/s1600/3D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8sculptra%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AE%25E7%25AB%25A5%25E9%25A1%258F%25E9%2587%259D%25E6%2589%2593%25E5%25A4%259A%25E5%25B0%2591CC%25E8%25B2%25BB%25E7%2594%25A8%25E5%25A4%259A%25E5%25B0%2591%25E9%258C%25A2%25E5%2583%25B9%25E6%25A0%25BC%25E6%2596%25B0%25E7%25AB%25B93d%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8%25E5%2583%25B9%25E6%25A0%25BC%25E6%2595%2588%25E6%259E%259C%25E7%258E%25BB%25E5%25B0%25BF%25E9%2585%25B8%25E9%259F%258C%25E5%25B8%25B6%25E6%258B%2589%25E6%258F%25901.jpg)
我們臉上有數條韌帶,關係到了我們輪廓線的緊緻及整體的視覺效果,都跟臉部老化表現症狀息息相關,更影響了臉部輪廓、線條緊實與否,尤其集中在中、下臉。中臉為臉部的視覺中心、焦點,下半臉則是影響了整張臉形(上述提到的鬆弛的臉型會使臉看起來呈現U型,年輕緊緻的臉型則是屬於V臉)。
整體組織下垂的禍首 臉部骨架、軟組織整體流失
![](https://1.bp.blogspot.com/--rGsZNMN4wI/WglpAyHcbfI/AAAAAAAAADE/CKhE6_0I7g8ilmivKd-vB3sxIlCboqf-ACLcBGAs/s1600/3D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8sculptra%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AE%25E7%25AB%25A5%25E9%25A1%258F%25E9%2587%259D%25E6%2589%2593%25E5%25A4%259A%25E5%25B0%2591CC%25E8%25B2%25BB%25E7%2594%25A8%25E5%25A4%259A%25E5%25B0%2591%25E9%258C%25A2%25E5%2583%25B9%25E6%25A0%25BC%25E7%258E%25BB%25E5%25B0%25BF%25E9%2585%25B8true%2Blift%25E6%2596%25B0%25E7%25AB%25B9%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB16.jpg)
另一個很重要的原因,則是由深至淺的各層組織流失。每一層都會發生,並非單純的只是膠原蛋白流失!!!包含支撐的臉部輪廓線條的深層骨骼萎縮,深層脂肪也會流失,皮下組織也會流失、位移。
抗老治療時,若追求的是整體的視覺年輕化,並且是在自然、精緻的前提下,必須針對真性韌帶鬆弛、各層流失全面性的治療。換句話說,在治療前的評估,找出並了解求診者老化、流失的情況,攸關著術後成敗與否。
至於如何不動刀,充分運用各種注射物,達到求診者心目中的「年輕樣貌」,那就是醫師的工作了。像是「玻尿酸」效果立即看見,若劑型挑選得當,用於韌帶的拉提、體積流失的補充,術後的反應都普遍不錯;但要注意的是,若過於關注「填補」,沒有經過適當的劑量分配,填充物只是整坨的補進去皮膚、沒有加強韌帶的緊實,就會有正面看好像不錯,低頭就破功的情況(如下圖),因此如何注射在正確、恰當的位置,支撐、加強鬆弛、毀損的構造,是個很重要的課題。
![](https://1.bp.blogspot.com/-HbWjA9qZPxQ/WhTmq4vBf_I/AAAAAAAAaI4/Umy6dkrmnzQhvbyjtWfdQhbu96QFm6s2wCLcBGAs/s1600/3D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8sculptra%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AE%25E7%25AB%25A5%25E9%25A1%258F%25E9%2587%259D%25E6%2589%2593%25E5%25A4%259A%25E5%25B0%2591CC%25E8%25B2%25BB%25E7%2594%25A8%25E5%25A4%259A%25E5%25B0%2591%25E9%258C%25A2%25E5%2583%25B9%25E6%25A0%25BC%25E7%258E%25BB%25E5%25B0%25BF%25E9%2585%25B8true-lift%25E6%2596%25B0%25E7%25AB%25B9%25E6%259E%2597%25E4%25BA%25AE%25E8%25BE%25B0%25E9%2586%25AB%25E5%25B8%25AB22.jpg)
![](https://1.bp.blogspot.com/-Wi1i5aFIb2I/Wbe2ig4EjdI/AAAAAAAAZEk/Uxzs5qpZC6ksixDz1WAsWhAhmOXF2mV5QCPcBGAYYCw/s1600/%25E7%258E%25BB%25E5%25B0%25BF%25E9%2585%25B8%25E6%2599%25B6%25E4%25BA%25AE%25E7%2593%25B7%25E5%25BE%25AE%25E6%2599%25B6%25E7%2593%25B7%25E5%25BE%25AE%25E6%2595%25B4%25E5%25BD%25A23D%25E8%2581%259A%25E5%25B7%25A6%25E6%2597%258B%25E4%25B9%25B3%25E9%2585%25B8%25E8%2588%2592%25E9%25A1%258F%25E8%2590%2583%25E6%25B6%25B2%25E6%2585%258B%25E6%258B%2589%25E7%259A%25AEsculptra7.png)
而刺激膠原蛋白生長的「3D聚左旋乳酸」,注射在不同的深度、位置,可以模擬骨骼構造,也可以緊實韌帶,同時可以補充流失的軟組織。除了臉上的皺紋、凹陷改善,正面看因為組織上提,臉型、線條趨於緊緻,側臉、低頭不同角度,線條也都完美。
不同的注射物有不同的特性、優勢,並非最新、最熱門的就是最棒的,醫師唯有找到老化的關鍵部位,運用不同注射物、優勢,透過不同的注射方式,深層打底,中淺層塑形、定型,計畫性、階段性地分次治療,才能打造緊實、年輕又自然的自己。