Aging – it is a multi-stage and multi-factorial process. The face of a person changes in more than one decade, and not only changes at the level of the skin reflect the withering of our face. Everything changes, from bone structures and ligaments to fat pads. Superficial and deep fat compartments ensure the maintenance of overlying tissues, create volume. Changes in the area of these anatomical formations are especially strongly reflected in the face.
On estet-portal.com, read what superficial fat packs exist, where they are located, and how to properly correct them.
- Anatomy of the face: location of superficial fat pads
- Aging processes of superficial fat pads
- Features of correction of superficial fat packs
Anatomy of the face: location of superficial fat pads
Infraorbital fat (IF) Its upper edge corresponds to the lacrimal sulcus and palpebromalar sulcus. The upper boundary of this package is the orbicular supporting ligament (ORL), which originates 1-2 mm below the bony edge of the orbit and, passing through the orbicular muscle of the eye, reaches the dermis. This ligament starts from the periosteum below the bony edge of the orbit and goes to the fascia lining the inner surface of the orbicular muscle of the eye. ORL promotes the lacrimal sulcus and palpebromalar sulcus.
Cranial to these two sulci, the orbicularis oculi muscle is located directly under the skin of the lower eyelid, its caudal part is covered with infraorbital fat. The lower border of the infraorbital fat pad is the zygomatic ligament. This fat pad has a high tendency to retain water, which often causes the formation of so-called. malar edema.
Superficial medial cheek fat (SMCF) has a triangular shape and located between the infraorbital and nasolabial fatpacks, caudal to the infraorbital fatpack from which it separated by the zygomatic ligament. The lateral boundary of this fat pack is the zygomaticus major muscle and the middle buccal fat pack. Below and medially to the superficial medial buccal fat pad is the nasolabial fat pad, located parallel to the nasolabial fold.
Nasolabial fat (NLF) It has an oblong shape, is located lateral to the nasal pyramid, parallel and cranial to the nasolabial fold. The ORL forms the upper boundary of this fat pack. It borders superficially on the superficial medial buccal fat pad, and the median buccal septum (or buccal-maxillary ligament) separates the two fat pads. Inferomedially, it borders on the nasolabial fold. Its lower part borders on the maxillary fat pad and overlaps it.
Middle cheek fat (MCF) Located lateral to the medial buccal fat pack, its upper border is the zygomaticocutaneous ligament. Above this packet, the bundle is thick and forms McGregor's point. The middle buccal fat package does not extend above the lower edge of the zygomatic arch. Anteriorly, it borders on the masticatory ligament, which begins below the McGregor point and descends vertically down along the anterior border of the masticatory muscle. This ligament originates from the fascia of the masticatory muscle, is woven into the SMAS and overlying dermis of the buccal region.
The median buccal fat pad laterally borders on the lateral temporo-buccal fat pad and is separated from it by the lateral buccal septum (or parotid masticatory septum). Caudal to the middle buccal fat pad is the maxillary fat pad.
Lateral temporal-cheek fat (LTCF) This is the most lateral cheek fat pack, it is in direct contact parotid gland and connects temporal fat pad with cervical subcutaneous fat. The buccal part fits snugly against the fascia of the parotid gland.
Superior jowl fat (SJF) Located below the nasolabial fat pad. Its lateral border — this is the average buccal fat pad.
Inferior jowl fat (IJF) Located lower in relation to middle buccal and maxillary fat packs. Its medial border — this is the mandibular ligament, and posterior border — lateral temporo-buccal fat pad. The lower border is formed by the mandibular septum.
The first three superficial fat pads (infraorbital fat pad, medial buccal fat pad and nasolabial fat pad) are described as a unique anatomical structure: malar fat pad (malar fat pad) ). It has a triangular shape with base parallel to the nasolabial fold, with apex in the region of the highest part of the malar area.
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muscles of the face to the skin.
Aging processes of superficial fat padsThe aging process causes
hypertrophy of the volume of the superficial medial buccal fat pad with slight ptosis of its lower part. Volume increases in the lower two-thirds and stays stable in the upper third.
Nasolabial fat pad (NLF). There is a slight shift in the volume of adipose tissue. In elderly patients, the sagittal diameter of the upper third becomes smaller, and the sagittal diameter of the lower third increases. These changes create a general hypertrophy of the lower part of the malar fat pad due to ptosis and caudal migration of adipose tissue.
Malar fat pad aging can be described as ptotic/hypertrophic, resulting in an increase in the depth of the nasolabial fold.Medium buccal fat pad (MCF). Like the malar fat pad, it is weakly attached to the SMAS plane, its aging process is characterized by ptosis, caudal fat migration and hypertrophy. These changes lead to an increase in the bulge of the central part of the cheek.
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Lateral temporo-buccal fat pad (LTCF). Tightly attached to the parotid fascia without any deep fat pad between them. Aging is determined by hypotrophic involution and usually does not tend to caudal migration.
Features of correction of superficial fat padsThe aging processes of superficial fat pads are characterized mainly by ptosis and hypertrophy. Only the lateral temporo-buccal fat package is distinguished by a hypotrophic aging process. Correction of superficial fat pads should be carried out with caution in order to avoid aggravation of ptosis. For this reason, it is recommended to use medium G’ fillers.
The infraorbital fat pad has a high tendency to retain water, so the use of HA fillers with a high degree of hydrophilicity may lead to increased edema.
medial buccal and nasolabial fat pads in order to complete the volume expansion initiated by injecting the drug into the area of the deep medial buccal fat pad.
Read also:Bypassing Dangerous Zones: Filler Injection Points
In patients
with ageing type 2only the medial buccal fat pad needs to be corrected. In patients
with ageing types 3 and 4the superficial buccal fat pads are initially hypertrophied, so their correction can lead to an increase in ptosis. Particular attention should be paid to the lateral temporo-buccal fat pad. Restoration of the volume of this package leads to reduction of the preauricular cavity and provides a lifting effect of the middle buccal fat package and soft tissues that form the line of the lower jaw.
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