Age-Related Changes of the Orbit and Midcheek and the Implications for Facial Rejuvenation

Mendelson, Bryan C.; Hartley, Winfield; Scott, Mark; McNab, Alan A.; Granzow, Jay W.

doi:10.1007/s00266-006-0120-x

Cited by 147 publications

(87 citation statements)

References 12 publications

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“…CT has been used to evaluate age-related changes in deeper facial structures such as facial bones. [6][7][8][9][10][11][12]23 Other studies have examined age-related volumetric changes in the facial soft tissue and described an increase in the orbital fat and lower eyelid fat, as well as selective atrophy in the cheek fat associated with increasing patient age. 1,[24][25][26][27] While prior studies have described the repositioning of facial soft tissues and the volume changes in the facial fat as primary contributors to the appearance of an older face, it is also possible that specific, age-related changes in facial tissue properties also contribute to the findings associated with an older appearing face.…”

Section: Introductionmentioning

confidence: 99%

“…The investigations into the mechanisms of facial ageing have revealed a multifactorial process involving a combination of structures with functional and structural changes including loss of elasticity, facial fat atrophy, weakened muscular support and bony remodelling. [1][2][3][4][5][6][7][8][9][10][11][12][13] These age-related changes ultimately lead to alteration in facial appearance with the characteristic wrinkle formation, deepened facial lines, soft tissue descent and prominence of the lower eyelids associated with an older facial appearance.…”

Section: Introductionmentioning

confidence: 99%

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MR relaxometry for the facial ageing assessment: the preliminary study of the age dependency in the MR relaxometry parameters within the facial soft tissue

Watanabe

Buch

Fujita

et al. 2015

Dentomaxillofacial Radiology

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Objectives: To investigate the location-specific tissue properties and age-related changes of the facial fat and facial muscles using quantitative MRI (qMRI) analysis of longitudinal magnetization (T1) and transverse magnetization (T2) values. Methods: 38 subjects (20 males and 18 females, 0.5-87 years old) were imaged with a mixed turbo-spin echo sequence at 1.5 T. T1 and T2 measurements were obtained within regions of interest in six facial fat regions including the buccal fat and subcutaneous cheek fat, four eyelid fat regions (lateral upper, medial upper, lateral lower and medial lower) and five facial muscles including the orbicularis oculi, orbicularis oris, buccinator, zygomaticus major and masseter muscles bilaterally. Results: Within the zygomaticus major muscle, age-associated T1 decreases in females and T1 increases in males were observed in later life with an increase in T2 values with age. The orbicularis oculi muscles showed lower T1 and higher T2 values compared to the masseter, orbicularis oris and buccinator muscles, which demonstrated small age-related changes. The dramatic age-related changes were also observed in the eyelid fat regions, particularly within the lower eyelid fat; negative correlations with age in T1 values (p , 0.0001 for age) and prominent positive correlation in T2 values in male subjects (p , 0.0001 for male 3 age). Age-related changes were not observed in T2 values within the subcutaneous cheek fat. Conclusions: This study demonstrates proof of concept using T1 and T2 values to assess agerelated changes of the facial soft tissues, demonstrating tissue-specific qMRI measurements and non-uniform ageing patterns within different regions of facial soft tissues. Dentomaxillofacial Radiology (2015) 44, 20150047. doi: 10.1259/dmfr.20150047 Cite this article as: Watanabe M, Buch K, Fujita A, Christiansen CL, Jara H, Sakai O. MR relaxometry for the facial ageing assessment: the preliminary study of the age dependency in the MR relaxometry parameters within the facial soft tissue. Dentomaxillofac Radiol 2015; 44: 20150047.Keywords: ageing; facial muscles; adipose tissue; magnetic resonance imaging; quantitative evaluation IntroductionThe face is a complex, multifunctional structure responsible for conveying various emotional expressions. The investigations into the mechanisms of facial ageing have revealed a multifactorial process involving a combination of structures with functional and structural changes including loss of elasticity, facial fat atrophy, weakened muscular support and bony Correspondence to: Dr Memi Watanabe. E-mail: memi.watanabe@bmc.org Cindy L Christiansen received funds from Department of Radiology, Boston University School of Medicine, for statistical support. Hernán Jara is named inventor in several patents held by Boston University and Boston Medical Center pertaining to quantitative MRI and Synthetic MRI algorithms and these could be licensed to a major MRI manufacturer (negotiations are taking place with GE Healthcare). Hernán Jara also has received royal...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

MR relaxometry for the facial ageing assessment: the preliminary study of the age dependency in the MR relaxometry parameters within the facial soft tissue

Watanabe

Buch

Fujita

et al. 2015

Dentomaxillofacial Radiology

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“…In youth, the upper anterior cheek skin is firmly supported by the orbitomalar septum that allows little or no downward migration (Mendelson et al, 2007). Facial septa extending from the SMAS through the malar fat pad to the overlying dermis further support the malar fat pad (Owsley, 1993).…”

Section: Soft Tissue Changes In Ageing Facementioning

confidence: 99%

“…Skeletal resorption, at both the periorbital level and maxillary level, has been attributed to the decreased malar projection and increased orbital aperture seen in ageing. This can have significant consequences on the projection and prominence of the maxilla and on the location of facial ligament attachments (Nahai, 2005;Mendelson et al, 2007). The maxilla may undergo significant skeletal resorption, with up to a 10° loss in the maxillary angle contributing to the typical ageing cheek stigmata associated with loss of maxillary projection and resulting in the development of a lid-cheek continuum deformity and a prominent nasolabial fold (Mendelson and Wong, 2012).…”

Section: Skeletal Architecture In the Ageing Facementioning

confidence: 99%

Textbook of Plastic and Reconstructive Surgery

Butler¹,

Ghali²,

Kalaskar³

2016

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A CIP catalogue record for this book is available from The British Library.This book is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at http://creativecommons.org/ licenses/by/4.0The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. The user is advised to always check the product information and clinical procedures with the most up-to-date published product information and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or misuse or misapplication of material in this work.ISBN: 978-1-910634-37-0 (Hbk.) ISBN: 978-1-910634-38-7 (Pbk.) ISBN: 978-1-910634-39-4 (PDF) ISBN: 978-1-910634-40-0 (epub) ISBN: 978-1-910634-41-7 (mobi)

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“…In the face, the skin loses collagen and elastic fibers, decreasing in vascularity and appendages, thus becoming thinner and flaccid. Fat compartments change the volumetric distribution, and the facial bones are in continuous remodeling throughout life [3][4][5][6][7][8][9][10] . Hence, in the midface, there is a deflation phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Tear trough – Anatomy and treatment by autologous fat grafting

Chia

2016

J Surg Dermatol

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Tear trough is the main irregularity at midface, of which treatment is difficult. There is no agreement in literature about its anatomy and best treatment. The author presented an anatomical study and personal autologous fat grafting technique for tear trough treatment. Anatomical dissections were done on two fresh cadavers to examine the skin, subcutaneous, muscle and bone layers, spaces, and attachments. Safety and efficacy were evaluated via retrospective analysis of the last 200 consecutive procedures performed by the author. Tear trough is caused by the abrupt transition of the palpebral orbicular oculi muscle (OOM) (i.e., thin skin without subcutaneous fat compartment) to the orbital OOM (i.e., thicker skin with malar fat compartment). The tear trough region is located at the OOM bony origin at the medial canthus where no specific ligament was found. The grafted fat volume stabilized at two or three months after the procedure, instead of six months as stated in literature, with excellent results and no severe complications. Tear trough is a personal characteristic, a natural anatomical depression caused by subcutaneous irregularity and can worsen with age. The lack of volume is not effectively corrected by surgeries and thus it must be filled. Fat grafting has several advantages over alloplastic fillers, although it may be more difficult. Fat graft is autologous and abundant, and tissue transplantation could enhance skin quality. Fat grafting is a simple, safe, and effective solution for adding extra volume to correct the deflation phenomenon of the midface aging process. There is no specific anatomical plane for volume injection; the fat graft must be evenly distributed in the deep and superficial plane for uniformity.

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Age-Related Changes of the Orbit and Midcheek and the Implications for Facial Rejuvenation

Cited by 147 publications

References 12 publications

MR relaxometry for the facial ageing assessment: the preliminary study of the age dependency in the MR relaxometry parameters within the facial soft tissue

MR relaxometry for the facial ageing assessment: the preliminary study of the age dependency in the MR relaxometry parameters within the facial soft tissue

Textbook of Plastic and Reconstructive Surgery

Tear trough – Anatomy and treatment by autologous fat grafting

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