Morphological study of human facial fascia and subcutaneous tissue structure by region through SEM observation. (December 2020) - Amano, Kaori
Highlights: Infra orbital region contains much less adipose tissue than other facial regions. Superior parotid region of the face retains most consistent skin layer thickness. Aging causes space between adipose compartments of facial subcutaneous tissue layer. Facial regions with less adipose tissue cause superficial skin to sag during aging. Abstract: Fascia of the facial area is contiguous between fat tissues of the subcutaneous and connective tissue layers and does not envelope the muscle surface like other parts of the human body. This structure is called the superficial musculoaponeurotic system (SMAS), which is accepted as an international anatomical terminology. This special structure is commonly used to pull facial muscles during plastic surgeries such as a face lift. Most reports regarding the facial subcutaneous tissue structure including SMAS are in the field of plastic surgery, and only a few studies from a morphological perspective has been reported. Since the facial fascia does not envelope the muscular surface layer which is different from the deep fascia found on the general skeletal muscle surface, a clear definition of this structure has not been established yet. The purpose of this study was to clearly identify the basic morphological structure of the subcutaneous tissue layer containing the SMAS three-dimensionally through a scanning electron microscope using dissected specimen rather than living subjects. Moreover, this study explores structural differences among seven aging facial areas; thereby further clarifying the properties of the structure and add clinical significance and considerations.