Facial cosmetic procedures are doubtless in constant augmentation directly related
to fillers and botulinum toxin injections. Many articles are published in the literature
to warn about the complications of these aesthetic procedures. The need for a clear
anatomic classification and review of deeper ultrastructural studies on adipose tissues
in the midface area are obvious. This study aims: (1) To present midface anatomy of
clinical relevance in a practical way for surgeons and cosmetologists. (2) To analyze
the facial fasciae related to the fat compartments. (3) To show pictures of anatomic
dissections of these anatomic structures. (4) To suggest an anatomic classification.
The authors analyzed the facial anatomic layers and the facial fat compartments through
facial anatomical dissections and experience in the field of facial surgical and cosmetic
procedures. The authors propose a dynamic three-dimensional concept of facial layers
related to muscle actions and facial fat compartmentalization in the midcheek area.
A “lip–lid” superficial system associated with the malar fat pad represents the first
layer; two deeper lip levator systems stratification explains the deep fat compartments
as an anatomic division related to fasciae extensions. Facial grooves and segments
correspond to these systems action. Moreover, the importance of ultrastructural studies
has been underlined.
Keywords
facial anatomy - facial fat compartments - facial layers - facial cosmetology
