Facial Fat Compartments: A Guide to Filler Placement

ABSTRACT

Advances in anatomic understanding are frequently the basis upon which surgical techniques are advanced and refined. Recent anatomic studies of the superficial tissues of the face have led to an increased understanding of the compartmentalized nature of the subcutaneous fat. This report provides a review of the locations and characteristics of the facial fat compartments and provides examples of how this knowledge can be used clinically, specifically with regard to soft tissue fillers.

KEYWORDS

Fat compartments - facial fat compartments - soft tissue fillers

REFERENCES

• 1 National Center for Health Statistics .Health, United States, 2006 with Chartbook on Trends in the Health of Americans. Hyattsville, MD; National Center for Health Statistics 2006
• 2 American Society of Plastic Surgeons .National clearinghouse of plastic surgery statistics: 2009 report of 2008 statistics. Available at: http://www.plasticsurgery.org/media/press_kits/procedural_statistics.html Accessed Aug. 04, 2007
• 3 Rogers B O. The development of aesthetic plastic surgery: a history.  Aesthetic Plast Surg. 1976;  1 3-24
• 4 Gonzales-Ulloa M. The history of rhytidectomy.  Aesthetic Plast Surg. 1980;  4 1-45
• 5 Lemmon M L, Hamra S T. Skoog rhytidectomy: a five-year experience with 577 patients.  Plast Reconstr Surg. 1980;  65 283-297
• 6 Hamra S T. The deep-plane rhytidectomy.  Plast Reconstr Surg. 1990;  86 53-61 discussion 62-63
• 7 Hamra S T. Composite rhytidectomy.  Plast Reconstr Surg. 1992;  90 1-13
• 8 Donofrio L M. Fat distribution: a morphologic study of the aging face.  Dermatol Surg. 2000;  26 1107-1112
• 9 Rohrich R J, Pessa J E. The retaining system of the face: histologic evaluation of the septal boundaries of the subcutaneous fat compartments.  Plast Reconstr Surg. 2008;  121 1804-1809
• 10 Schaverien M V, Pessa J E, Rohrich R J. Vascularized membranes determine the anatomical boundaries of the subcutaneous fat compartments.  Plast Reconstr Surg. 2009;  123 695-700
• 11 Hatef D A, Hollier Jr L H. Vascularized membranes determine the anatomical boundaries of the subcutaneous fat compartments.  Plast Reconstr Surg. 2009;  124 315-316
• 12 Rohrich R J, Pessa J E. The fat compartments of the face: anatomy and clinical implications for cosmetic surgery.  Plast Reconstr Surg. 2007;  119 2219-2227 discussion 2228-2231
• 13 Moss C J, Mendelson B C, Taylor G I. Surgical anatomy of the ligamentous attachments in the temple and periorbital regions.  Plast Reconstr Surg. 2000;  105 1475-1490 discussion 1491-1498
• 14 Castanares S. Blepharoplasty for herniated intraorbital fat: anatomical basis for a new approach.  Plast Reconstr Surg. 1951;  8 46-58
• 15 Barker D E. Dye injection studies of intraorbital fat compartments.  Plast Reconstr Surg. 1977;  59 82-85
• 16 Gradinger G P. Cosmetic upper blepharoplasty.  Clin Plast Surg. 1988;  15 289-297
• 17 Niechajev I A, Ljungqvist A. Central (third) fat pad of the upper eyelid.  Aesthetic Plast Surg. 1991;  15 223-228
• 18 Ullmann Y, Levi Y, Ben-Izhak O, Har-Shai Y, Peled I J. The surgical anatomy of the fat in the upper eyelid medial compartment.  Plast Reconstr Surg. 1997;  99 658-661
• 19 Rohrich R J, Pessa J E, Ristow B. The youthful cheek and the deep medial fat compartment.  Plast Reconstr Surg. 2008;  121 2107-2112
• 20 Rohrich R J, Pessa J E. The anatomy and clinical implications of perioral submuscular fat.  Plast Reconstr Surg. 2009;  124 266-271
• 21 Reece E M, Pessa J E, Rohrich R J. The mandibular septum: anatomical observations of the jowls in aging-implications for facial rejuvenation.  Plast Reconstr Surg. 2008;  121 1414-1420
• 22 Pessa J E. An algorithm of facial aging: verification of Lambros's theory by three-dimensional stereolithography, with reference to the pathogenesis of midfacial aging, scleral show, and the lateral suborbital trough deformity.  Plast Reconstr Surg. 2000;  106 479-488
• 23 Lambros V. Observations on periorbital and midface aging.  Plast Reconstr Surg. 2007;  120 1367-1376 discussion 1377
• 24 Pessa J E, Zadoo V P, Mutimer K L et al.. Relative maxillary retrusion as a natural consequence of aging: combining skeletal and soft-tissue changes into an integrated model of midfacial aging.  Plast Reconstr Surg. 1998;  102 205-212
• 25 Gonzalez-Ulloa M, Flores E S. Senility of the face: basic study to understand its causes and effects.  Plast Reconstr Surg. 1965;  36 239-246
• 26 Guyuron B, Rowe D J, Weinfeld A B, Eshraghi Y, Fathi A, Iamphongsai S. Factors contributing to the facial aging of identical twins.  Plast Reconstr Surg. 2009;  123 1321-1331