Ocean Clinic, Marbella, Spain.
Division of Hand, Plastic and Aesthetic Surgery, Ludwig - Maximilian University Munich, Munich, Germany.
Aesthetic Plast Surg. 2024 Sep;48(18):3568-3576. doi: 10.1007/s00266-024-04070-6. Epub 2024 May 9.
Surgical, minimally-invasive, and non-invasive aesthetic procedures try to ameliorate the signs of facial aging, but also focus on enhancing various individual features of beauty in each patient. Herein, the midface plays a central role due to its location but also its importance for the aesthetic perception and facial expression.
To date, no study has investigated the interplay between facial muscles and its connecting subdermal architecture during facial aging to provide a more comprehensive understanding of the middle face.
A total of 76 subjects, consisting of 30 males (39.5%) and 46 females (60.5%) with a mean age of 42.2 (18.7) years [range 19-80] and a mean BMI of 24.6 (3.7) kg/m [range 18-35], were enrolled in this investigation. Cutometry (skin aging), 3D skin displacement analyses (subdermal connective tissue aging), and sEMG (muscle aging) analyses were utilized.
The results revealed that overall skin firmness increased, and skin elasticity decreased (p < 0.001), sEMG signal of the investigated muscles decreased (p < 0.001), whereas midfacial mobility remained unaltered (p = 0.722).
The results of this study indicate that midfacial aging is a measurable effect when utilizing individual measurement modalities for assessing skin, subdermal fascia, and midfacial muscles. The function of midfacial muscles revealed a potential threshold effect, which is not reached during midfacial aging due to the unchanged soft tissue mobility at older age. However, to understand its clinical presentation all midfacial soft tissues need to be factored in and a holistic picture needs to be created.
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外科、微创和非侵入性美容程序试图改善面部衰老的迹象，但也侧重于增强每个患者的各种个体美丽特征。在此，中面部因其位置以及对面部美观和表情的重要性而发挥核心作用。
迄今为止，尚无研究调查面部肌肉与其连接的真皮下结构在面部衰老过程中的相互作用，以提供对面中部的更全面理解。
共纳入 76 名受试者，包括 30 名男性（39.5%）和 46 名女性（60.5%），平均年龄为 42.2（18.7）岁[范围 19-80]，平均 BMI 为 24.6（3.7）kg/m[范围 18-35]，参与了本研究。使用皮肤测量法（皮肤老化）、3D 皮肤位移分析（真皮下结缔组织老化）和 sEMG（肌肉老化）分析。
结果显示，整体皮肤紧实度增加，皮肤弹性降低（p<0.001），研究肌肉的 sEMG 信号降低（p<0.001），而中面部活动性保持不变（p=0.722）。
本研究结果表明，当使用评估皮肤、真皮下筋膜和中面部肌肉的个体测量方式时，中面部衰老可作为一种可测量的效果。中面部肌肉的功能显示出潜在的阈值效应，由于在老年时软组织活动性不变，因此在中面部衰老过程中不会达到该效应。然而，为了理解其临床表现，需要考虑所有中面部软组织，并创建一个整体图像。
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