Thilo L Schenck1,2, Konstantin C Koban1,2, Alexander Schlattau1,2, Konstantin Frank1,2, Jonathan M Sykes1,2, Stefan Targosinski1,2, Katharina Erlbacher1,2, Sebastian Cotofana1,2. 1. Munich, Germany; Salzburg, Austria; Sacramento, Calif.; Albany, N.Y.; and Zurich, Switzerland. 2. From the Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians University; the Department of Radiology, Paracelsus Medical University Salzburg and Nuremberg; the Department of Cell Biology and Physiology, University of Salzburg, the Department of Facial Plastic Surgery, University of California-Davis Medical Center; the Department of Medical Education, Albany Medical College; and the Division of Thoracic Surgery, University Hospital Zurich.
Abstract
BACKGROUND: The superficial (subcutaneous) facial fat compartments contribute to the signs of facial aging, but a comprehensive anatomical description of their location and their functional behavior during the application of soft-tissue fillers remains elusive. METHODS: The authors investigated 30 fresh frozen cephalic specimens from 13 male and 17 female Caucasian body donors (age, 78.3 ± 14.2 years; body mass index, 23.1 ± 5.3 kg/m(2)). Upright-position, contrast-enhanced computed tomographic scanning, and additional magnetic resonance imaging were performed. Three-dimensional reconstruction-based measures were conducted to evaluate the position of the applied contrast agent in each compartment separately. Successive anatomical dissections were performed to confirm the imaging findings. RESULTS: Positive correlations were detected between the amounts of injected material and the inferior displacement for the superficial nasolabial (rp = 0.92, p = 0.003), middle cheek (rp = 0.70, p = 0.05), and jowl (rp = 0.92, p = 0.03) compartments but not for the medial cheek (rp = 0.20, p = 0.75), lateral cheek (rp = 0.15, p = 0.75), or the superior (rp = -0.32, p = 0.41) or inferior superficial temporal compartment (rp = -0.52, p = 0.29). CONCLUSION: This study confirms the presence of distinct subcutaneous fat compartments and provides evidence for an individual behavior when soft-tissue fillers are applied: inferior displacement of the superficial nasolabial, middle cheek, and jowl compartments, in contrast to an increase in volume without displacement (i.e., an increase in projection) of the medial cheek, lateral cheek, and both superficial temporal compartments.
BACKGROUND: The superficial (subcutaneous) facial fat compartments contribute to the signs of facial aging, but a comprehensive anatomical description of their location and their functional behavior during the application of soft-tissue fillers remains elusive. METHODS: The authors investigated 30 fresh frozen cephalic specimens from 13 male and 17 female Caucasian body donors (age, 78.3 ± 14.2 years; body mass index, 23.1 ± 5.3 kg/m(2)). Upright-position, contrast-enhanced computed tomographic scanning, and additional magnetic resonance imaging were performed. Three-dimensional reconstruction-based measures were conducted to evaluate the position of the applied contrast agent in each compartment separately. Successive anatomical dissections were performed to confirm the imaging findings. RESULTS: Positive correlations were detected between the amounts of injected material and the inferior displacement for the superficial nasolabial (rp = 0.92, p = 0.003), middle cheek (rp = 0.70, p = 0.05), and jowl (rp = 0.92, p = 0.03) compartments but not for the medial cheek (rp = 0.20, p = 0.75), lateral cheek (rp = 0.15, p = 0.75), or the superior (rp = -0.32, p = 0.41) or inferior superficial temporal compartment (rp = -0.52, p = 0.29). CONCLUSION: This study confirms the presence of distinct subcutaneous fat compartments and provides evidence for an individual behavior when soft-tissue fillers are applied: inferior displacement of the superficial nasolabial, middle cheek, and jowl compartments, in contrast to an increase in volume without displacement (i.e., an increase in projection) of the medial cheek, lateral cheek, and both superficial temporal compartments.
Authors: Claudia A Hernandez; Michael Alfertshofer; Konstantin Frank; Lysander Freytag; Diana L Gavril; Kristina Davidovic; Robert H Gotkin; Arnaldo Mercado-Perez; Samir Mardini; Sebastian Cotofana Journal: Aesthetic Plast Surg Date: 2022-06-01 Impact factor: 2.326
Authors: Jani van Loghem; Sonja Sattler; Gabriela Casabona; Sebastian Cotofana; Sabrina Guillen Fabi; Kate Goldie; Uliana Gout; Martina Kerscher; Ting Song Lim; Carla de Sanctis Pecora; Gerhard Sattler; Ada Trindade de Almeida; Rungsima Wanitphakdeedecha; Philip Werschler; Tatjana Pavicic Journal: Clin Cosmet Investig Dermatol Date: 2021-09-08
Authors: Claudia A Hernandez; John Mario Espinal; David Uribe Zapata; Daniel Coimbra; Michael Alfertshofer; Konstantin Frank; Jeremy B Green; Kristina Davidovic; Diana L Gavril; Sebastian Cotofana Journal: Aesthetic Plast Surg Date: 2021-05-13 Impact factor: 2.326