Rohrich Rod J, Pessa Joel E, Ristow Brunno
Dallas, Texas, and San Francisco, Calif. From the Department of Plastic Surgery, University of Texas Southwestern Medical School, and from California Pacific Medical Center.
Plast Reconstr Surg. 2008 Jun;121(6):2107-2112. doi: 10.1097/PRS.0b013e31817123c6.
This article introduces the concept of pseudoptosis as a mechanism of midfacial aging: diminished volume of a specific deep fat compartment leads to an excess skin envelope and the illusion of a more prominent nasolabial fold. Tha anatomy of this deep fat compartment, and of two others, is described.
Fourteen hemifacial cadaver dissections were performed using the dye injection technique to identify deep medial cheek, submentalis, and sub-orbicularis oris fat compartments. Latex injection was used to investigate the arterial supply.
The deep medial fat compartment was defined in each subject. Two separate areas of deep medial fat exist. The more medial compartment abuts the pyriform membrane. The lateral component lies directly on the maxilla. The anatomy of submentalis and suborbicularis fat was defined.
Loss of volume of deep medial cheek fat leads to pseudoptosis and is an additional determinant of the nasolabial fold. Augmentation of deep medial fat has four effects: it increases anterior projection (not addressed by lateral redraping alone); it diminishes the nasolabial fold; the V-deformity is corrected; and a youthful cheek with natural boundaries is recreated. The term "malar fat" is probably a misnomer: this region is composed of both distinct superficial and deep fat compartments. Submentalis and sub-orbicularis oris fat play a role is the formation of the labiomental hollow and aging lip respectively. Understanding the anatomy of this area lends greater precision to our ability to rejuvenate the aging face.
本文介绍了假性上睑下垂作为中面部衰老机制的概念：特定深层脂肪隔的体积减小会导致皮肤包膜过多，并产生鼻唇沟更明显的错觉。描述了该深层脂肪隔以及另外两个脂肪隔的解剖结构。
使用染料注射技术对14例半侧面部尸体进行解剖，以识别内侧深层脸颊、颏下和口轮匝肌下脂肪隔。使用乳胶注射来研究动脉供应。
在每个受试者中确定了内侧深层脂肪隔。存在两个独立的内侧深层脂肪区域。较内侧的脂肪隔邻接梨状膜。外侧部分直接位于上颌骨上。确定了颏下和口轮匝肌下脂肪的解剖结构。
内侧深层脸颊脂肪体积的减少会导致假性上睑下垂，并且是鼻唇沟的另一个决定因素。增加内侧深层脂肪有四个作用：增加前突（单独的外侧皮肤重新悬吊无法解决）；减少鼻唇沟；纠正V形畸形；重塑具有自然边界的年轻脸颊。“颧脂肪”这个术语可能是一个误称：该区域由不同的浅表和深层脂肪隔组成。颏下和口轮匝肌下脂肪分别在唇颏沟凹陷和唇部衰老的形成中起作用。了解该区域的解剖结构可以提高我们对面部年轻化的精准操作能力。
