Facial plast Surg 2016; 32(06): 671-682
DOI: 10.1055/s-0036-1596046
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The Facial Adipose Tissue: A Revision

Ilja Kruglikov1, Oscar Trujillo2, Quick Kristen3, Kerelos Isac3, Julia Zorko3, Maria Fam3, Kasie Okonkwo3, Asima Mian3, Hyunh Thanh3, Konstantin Koban4, Anthony P. Sclafani2, Hanno Steinke5, Sebastian Cotofana3, 6
  • 1Scientific Department, Wellcomet GmbH, Karlsruhe, Germany
  • 2Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, New York
  • 3Department of Anatomy, Ross University School of Medicine, Roseau, West Indies
  • 4Department of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians University, Munich, Germany
  • 5Department of Medicine, Institute of Anatomy, University of Leipzig, Leipzig, Germany
  • 6Institute of Anatomy, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
Further Information

Publication History

Publication Date:
29 December 2016 (online)


Recent advantages in the anatomical understanding of the face have turned the focus toward the subcutaneous and deep facial fat compartments. During facial aging, these fat-filled compartments undergo substantial changes along with other structures in the face. Soft tissue filler and fat grafting are valid methods to fight the signs of facial aging, but little is known about their precise effect on the facial fat. This narrative review summarizes the current knowledge about the facial fat compartments in terms of anatomical location, histologic appearance, immune-histochemical characteristics, cellular interactions, and therapeutic options. Three different types of facial adipose tissue can be identified, which are located either superficially (dermal white adipose tissue) or deep (subcutaneous white adipose tissue): fibrous (perioral locations), structural (major parts of the midface), and deposit (buccal fat pad and deep temporal fat pad). These various fat types differ in the size of the adipocytes and the collagenous composition of their extracellular matrix and thus in their mechanical properties. Minimal invasive (e.g., soft tissue fillers or fat grafting) and surgical interventions aiming to restore the youthful face have to account for the different fat properties in various facial areas. However, little is known about the macro- and microscopic characteristics of the facial fat tissue in different compartments and future studies are needed to reveal new insights to better understand the process of aging and how to fight its signs best.