Kruglikov Ilja, Trujillo Oscar, Kristen Quick, Isac Kerelos, Zorko Julia, Fam Maria, Okonkwo Kasie, Mian Asima, Thanh Hyunh, Koban Konstantin, Sclafani Anthony P, Steinke Hanno, Cotofana Sebastian
Scientific Department, Wellcomet GmbH, Karlsruhe, Germany.
Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, New York.
Facial Plast Surg. 2016 Dec;32(6):671-682. doi: 10.1055/s-0036-1596046. Epub 2016 Dec 29.
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.
近年来，对面部解剖学认识的进展使人们将关注点转向皮下和面部深层脂肪间隔。在面部衰老过程中，这些充满脂肪的间隔与面部其他结构一样会发生显著变化。软组织填充剂和脂肪移植是对抗面部衰老迹象的有效方法，但它们对面部脂肪的确切影响却鲜为人知。这篇叙述性综述从解剖位置、组织学外观、免疫组织化学特征、细胞相互作用和治疗选择等方面总结了目前关于面部脂肪间隔的知识。可以识别出三种不同类型的面部脂肪组织，它们要么位于浅表（真皮白色脂肪组织），要么位于深层（皮下白色脂肪组织）：纤维型（口周部位）、结构型（中面部主要部分）和沉积型（颊脂垫和颞深脂肪垫）。这些不同类型的脂肪在脂肪细胞大小及其细胞外基质的胶原成分方面存在差异，因而在机械性能上也有所不同。旨在恢复年轻面容的微创干预（如软组织填充剂或脂肪移植）和手术干预必须考虑不同面部区域的脂肪特性差异。然而，对于不同间隔内面部脂肪组织的宏观和微观特征知之甚少，未来还需要开展研究以揭示新的见解，从而更好地理解衰老过程以及如何最佳地对抗衰老迹象。
