Surek Christopher C, Beut Javier, Stephens Robert, Jelks Glenn, Lamb Jerome
Kansas City, Kan.; New York, N.Y.; Independence, Mo.; and Palma de Mallorca, Spain From the Department of Plastic Surgery, University of Kansas Medical Center; the Department of Anatomy, Kansas City University of Medicine and Biosciences; the Department of Plastic and Reconstructive Surgery, New York University; private practice; and Instituto Dr. Beut.
Plast Reconstr Surg. 2015 May;135(5):818e-829e. doi: 10.1097/PRS.0000000000001226.
The study was conducted to construct an anatomically inspired midfacial analysis facilitating safe, accurate, and dynamic nonsurgical rejuvenation. Emphasis is placed on determining injection target areas and adverse event zones.
Twelve hemifacial fresh cadavers were dissected in a layered fashion. Dimensional measurements between the midfacial fat compartments, prezygomatic space, mimetic muscles, and neurovascular bundles were used to develop a topographic analysis for clinical injections.
A longitudinal line from the base of the alar crease to the medial edge of the levator anguli oris muscle (1.9 cm), lateral edge of the levator anguli oris muscle (2.6 cm), and zygomaticus major muscle (4.6 cm) partitions the cheek into two aesthetic regions. A six-step facial analysis outlines three target zones and two adverse event zones and triangulates the point of maximum cheek projection. The lower adverse event zone yields an anatomical explanation to inadvertent jowling during anterior cheek injection. The upper adverse event zone localizes the palpebral branch of the infraorbital artery. The medial malar target area isolates quadrants for anterior cheek projection and tear trough effacement. The middle malar target area addresses lid-cheek blending and superficial compartment turgor. The lateral malar target area highlights lateral cheek projection and locates the prezygomatic space.
This stepwise analysis illustrates target areas and adverse event zones to achieve midfacial support, contour, and profile in the repose position and simultaneous molding of a natural shape during animation. This reproducible method can be used both procedurally and in record-keeping for midface volumizing procedures.
本研究旨在构建一种受解剖学启发的面中部分析方法，以促进安全、准确且动态的非手术面部年轻化。重点在于确定注射目标区域和不良事件区域。
对12具半侧面部新鲜尸体进行分层解剖。测量面中部脂肪隔、颧前间隙、表情肌和神经血管束之间的尺寸，以开展用于临床注射的地形分析。
从鼻翼沟底部至提口角肌内侧缘（1.9厘米）、提口角肌外侧缘（2.6厘米）和颧大肌（4.6厘米）的一条纵线将脸颊分为两个美学区域。一个六步面部分析勾勒出三个目标区域和两个不良事件区域，并确定了脸颊最大突出点。较低的不良事件区域为前脸颊注射时意外出现的下颌赘肉提供了解剖学解释。较高的不良事件区域确定了眶下动脉的睑支位置。内侧颧部目标区域分离出用于前脸颊突出和泪沟消除的象限。中间颧部目标区域解决眼睑-脸颊融合和浅层隔室充盈问题。外侧颧部目标区域突出外侧脸颊突出并确定颧前间隙位置。
这种逐步分析阐明了目标区域和不良事件区域，以在静止状态下实现面中部的支撑、轮廓和外形，并在面部活动时同时塑造自然形状。这种可重复的方法可用于面中部容积增加手术的操作过程和记录保存。
