康碧君 李伟

[摘要]颈部皱纹的出现是体现人体衰老状态最突出的特征之一。随着颈部皱纹呈低龄化的趋势，以及医美的普及与接受程度升高，颈部除皱越来越受重视。颈部皱纹通常按走向分为颈阔肌纹和颈横纹。不同类型的颈部皱纹涉及不同的病因、机制、病理和临床表现。颈部皱纹的治疗方法有手术治疗、生物治疗、光电治疗以及填充治疗，每种治疗方法各有优缺点和相关适应证及并发症。本文将对以上内容进行详细阐述，讨论目前颈部皱纹治疗的新进展，为颈部皱纹的临床治疗提供更开阔的思路。

[关键词]颈部皱纹;除皱术;激光;肉毒毒素;填充物

[中图分类号]R616.4    [文献标志码]A    [文章编号]1008-6455（2020）07-0176-04

Abstract： The appearance of neck wrinkles is one of the most prominent features of the human aging state. Neck wrinkles are thought highly due to the low age tendency and the popularity and acceptance of rhytidectomy. Neck wrinkles are usually divided into platysma band and horizontal neck lines according to the direction. Different types of neck wrinkles are involved in different causes， mechanism， pathology and clinical performance.The treatment methods of neck wrinkles include surgical treatment，biological treatment，photovoltaic treatment and filling treatment. Each treatment method has its own advantages， disadvantages and related complications. This article describes neck wrinkles what is said above in detail，and discusses the latest research progress of various treatment methods，for providing various perspective for the clinical treatments of neck wrinkles.

Key words： neck wrinkles; rhytidectomy; laser; botulinum toxin;filler

皮肤老化是人体老化的外部表现[1]。颈部的老化能最直接地反映人的衰老状态。颈部衰老的主要特征有皮肤松弛、下垂、颈阔肌带和颏下脂肪堆积[2-5]。颈部皱纹的形成有外源性因素和内源性因素。外源性因素包括光老化、长期低头姿势、不良生活习惯、使用劣质化学品等，内源性因素主要为年龄的增长。

1  颈部皱纹的分类

颈部皱纹一般可分为体位性皱纹、动力性皱纹、重力性皱纹和混合性皱纹[1]。由于颈部有着特殊的解剖结构，颈部皱纹从方向上还可分为纵向的颈阔肌纹和横向的颈横纹。颈阔肌纹为颈阔肌松垂和颈部下垂的皮肤、皮下组织共同引起，呈“火鸡脖子样”改变，为重力性皱纹。生理性颈纹为颈部特有皮纹，出生即有，一般为两条，为皮下纵向纤维增厚而脂肪较少所致，将表皮、膜层、深筋膜固定在一起[6]。……