Department of Oral & Maxillofacial Surgery, Christian-Albrechts-University Kiel, Arnold-Heller-Strasse 16, 24105 Kiel, Germany.
J Plast Reconstr Aesthet Surg. 2012 Oct;65(10):1292-7. doi: 10.1016/j.bjps.2012.04.047. Epub 2012 May 31.
The ideal treatment of the nasolabial fold, the tear trough, the labiomandibular fold and the mentolabial sulcus is still discussed controversially. The detailed topographical anatomy of the fat compartments may clarify the anatomy of facial folds and may offer valuable information for choosing the adequate treatment modality. Nine non-fixed cadaver heads in the age range between 72 and 89 years (five female and four male) were investigated. Computed tomographic scans were performed after injection of a radiographic contrast medium directly into the fat compartments surrounding prominent facial folds. The data were analysed after multiplanar image reconstruction. The fat compartments surrounding the facial folds could be defined in each subject. Different arrangement patterns of the fat compartments around the facial rhytides were found. The nasolabial fold, the tear trough and the labiomandibular fold represent an anatomical border between adjacent fat compartments. By contrast, the glabellar fold and the labiomental sulcus have no direct relation to the boundaries of facial fat. Deep fat, underlying a facial rhytide, was identified underneath the nasolabial crease and the labiomental sulcus. In conclusion, an improvement by a compartment-specific volume augmentation of the nasolabial fold, the tear trough and the labiomandibular fold is limited by existing boundaries that extend into the skin. In the area of the nasolabial fold and the mentolabial sulcus, deep fat exists which can be used for augmentation and subsequent elevation of the folds. The treatment of the tear trough deformity appears anatomically the most challenging area since the superficial and deep fat compartments are separated by an osseo-cutaneous barrier, the orbicularis retaining ligament. In severe cases, a surgical treatment should be considered. By contrast, the glabellar fold shows the most simple anatomical architecture. The fold lies above one subcutaneous fat compartment that can be used for augmentation.
鼻唇沟、泪槽、唇颌沟和颏唇沟的理想治疗方法仍存在争议。脂肪隔室的详细局部解剖结构可以阐明面皱襞的解剖结构，并为选择合适的治疗方式提供有价值的信息。本研究共纳入 9 具年龄在 72 至 89 岁之间（5 名女性，4 名男性）的非固定尸体头颅。在向周围突出的面皱襞的脂肪隔室内直接注射造影剂后，进行 CT 扫描。对多平面图像重建后的数据进行分析。在每个研究对象中，都可以确定围绕面皱襞的脂肪隔室。研究发现，围绕面皱襞的脂肪隔室存在不同的排列模式。鼻唇沟、泪槽和唇颌沟代表相邻脂肪隔室之间的解剖边界。相比之下，眉间皱襞和颏唇沟与面脂肪无直接关系。在鼻唇沟和颏唇沟下方可以识别到位于面皱襞下方的深部脂肪。总之，通过特定隔室的体积填充来改善鼻唇沟、泪槽和唇颌沟的效果受到延伸至皮肤的现有边界的限制。在鼻唇沟和颏唇沟区域存在深部脂肪，可以用于填充和随后提升这些皱襞。泪槽畸形的治疗似乎是解剖上最具挑战性的区域，因为浅层和深层脂肪隔室之间存在一个由眼轮匝肌保留韧带分隔的骨皮屏障。在严重的情况下，应考虑手术治疗。相比之下，眉间皱襞具有最简单的解剖结构。该皱襞位于一个可以用于填充的皮下脂肪隔室内。
