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Plast Reconstr Surg. 2012 Jan;129(1):263-73. doi: 10.1097/PRS.0b013e3182362b96.

Aging changes of the midfacial fat compartments: a computed tomographic study.

Author information

1
Department of Oral and Maxillofacial Surgery, Christian-Albrechts-University, University of Erlangen-Nuremberg, Kiel and Erlangen, Germany. gierloff@mkg.uni-kiel.de

Abstract

BACKGROUND:

The restoration of a natural volume distribution is a major goal in facial rejuvenation. The aims of this study were to establish a radiographic method enabling effective measurements of the midfacial fat compartments and to compare the anatomy between human cadavers of younger versus older age.

METHODS:

Data from computed tomographic scans of 12 nonfixed cadaver heads, divided into two age groups (group 1, 54 to 75 years, n = 6; and group 2, 75 to 104 years, n = 6), were analyzed. For evaluation of the volume distribution within a specific compartment, the sagittal diameter of the upper, middle, and lower thirds of each compartment was determined. For evaluation of a "sagging" of the compartments, the distance between the cephalad border and the infraorbital rim was determined.

RESULTS:

Computed tomography enables a reproducible depiction of the facial fat compartments and reveals aging changes. The distance between the fat compartments and the infraorbital rim was higher in group 2 compared with group 1. The sagittal diameter of the lower third of the compartments was higher, and the sagittal diameter of the upper third was smaller in group 2 compared with group 1. The buccal extension of the buccal fat pad was shown to be an independent, separate compartment.

CONCLUSIONS:

This study demonstrates an inferior migration of the midfacial fat compartments and an inferior volume shift within the compartments during aging. Additional distinct compartment-specific changes (e.g., volume loss of the deep medial cheek fat and buccal extension of the buccal fat pad) contribute to the appearance of the aged face.

PMID:
21915077
DOI:
10.1097/PRS.0b013e3182362b96
[Indexed for MEDLINE]
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