Anatomy and imaging of the deep fat of the face

Kahn, J.-L.; Wolfram-Gabel, R.; Bourjat, P

doi:10.1002/1098-2353(2000)13:5<373::aid-ca7>3.0.co;2-w

Cited by 81 publications

(61 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The main feature of the soft tissues is their higher inconstancy, mobility in comparison with bones so the former are vastly subjected to adaptive and age related changes. Bachat fat pad (BFP) consists of a main part -the body, and several extensions arising from it: masseteric extension, preigomandibular extension, orbital extension, pterygopalatine extension, temporal extension (Kahn, J.L., Wolfram-Gabel, R. & Bourjat, P., 2000, Yousuf, S. et al, 2010. The extension`s anatomy is spatially complex, because they fill the space between the masticatory muscles (m. masseter, m. pterygoideus medialis et lateralis, m. temporalis).…”

Section: Introductioncontrasting

confidence: 68%

“…The only fact that can explain this is that on the CT's the strong fibrosis ( fig.7) of the resected buccal part was observed, so it hinders the temporal and the latter parts to prolapse into the freed space. On the other hand, we know that the Bichat fat pad has a developed capsule only in the cheek area, the part that is enclosed between the muscles has loose septs connected directly to the epimiseum of masticatory muscles (Kahn, J.L., Wolfram-Gabel, R. & Bourjat, P., 2000), and they could prevent the alteration in the volumetric appearance of the temporal area.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ct Anatomy of Buccal Fat Pad and Its Role in Volumetric Alterations of Face

Guryanov

Guryanov²

2015

Int. Arch. Photogramm. Remote Sens. Spatial Inf. Sci.

View full text Add to dashboard Cite

ABSTRACT:The aim of our study is the revision of the anatomy of buccal fat pad and its role in a volumetric pattern of face. Bichat fat pad is a fatty anatomical structure with body and numerous process enclosed between the bony and muscular structures in temporal, pterygopalatine fossae and extents to the cheek area. Nevertheless, the opinion about its structure and role in forming of volume pattern of face sometimes could be controversial. The Bichat fat pad consists on predominately hormone insensitive fat tissue with underdeveloped stroma, this leads to the stability of the fat pad volume and lesser radiodensity in contrast to the subcutaneous fat. Moreover, the buccal fat pad is delimited from the subcutaneous fat of cheek area by the strong capsule. This feature allows us to use CT to divide the Bichat fat pad from the surrounding tissues. The thorough embryological data provide the distinction of Bichat fat pad from the subcutaneous fat of cheek area even at the stage of development. On the other hand, the border between the masticatory muscles and the processes of the fat pad is not evident and resembles cellular spaces in the other anatomical areas. To elicit the role of the buccal fat pad in volume pattern of face and its function we have performed the several experiments, analyzed the postoperative results after Bichat fat pad resection using surface scanner and CT data. At first, we have performed the gravity test: the patient's face photogrammetry scanning in horizontal and vertical position of head and it revealed the excess of volume in temporal area in horizontal position. To exclude mechanism of overflowing of the skin and subcutaneous fat over the zygomatic arch we have placed the markers on the skin surface at the different areas of face including the projection of ligaments and found out that the migration of soft tissue over the zygomatic arch is about 3-5 mm and almost the same in temporal area. However, the acquired result was unsatisfying because cannot exclude completely the migration of superficial tissues. In following experiments it was shown that the intensive pressure on the cheek area in vertical position produce the volume excess in the temporal area similar and more exaggerate than in gravity test. To correlate the excess of tissue with underlying anatomical structures we had acquired the CT's of some probationers, performed 3D reconstruction of bony structures, Bichat fat pad, and aligned with the previous surface scans. The projection of this excess in both experiments corresponds with the temporal process of Bichat fat pad. That means that the leading mechanism of these changes is protrusion of temporal process of Bichat fat pad through the leaves of temporal fascia due to pressure on the buccal extension: in these conditions, the buccal fat pad works as a communicating vessel between the cheek area and temporal fossa. This fact has suggested us that the phenomenon of the deepening of temporal area during the ageing could be produced as by the atrophy of buccal fat pad as by t...

show abstract

Section: Introductioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Ct Anatomy of Buccal Fat Pad and Its Role in Volumetric Alterations of Face

Guryanov

Guryanov²

2015

Int. Arch. Photogramm. Remote Sens. Spatial Inf. Sci.

View full text Add to dashboard Cite

show abstract

“…These findings are compatible with the histological observation that the buccal fat consists of pure white fat with very few fibrous trabeculae and has a stable function as an intramuscular sliding structure. 41 However, in this study, T1 values of the buccal fat were higher than those of the subcutaneous fat, which is histologically much more fibrous. 41 Considering relatively high T2 values in both buccal and subcutaneous fat, one possible explanation would be the presence of less fluid in the superficial fat tissue.…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

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...

show abstract

“…Anatomical studies have demonstrated that the BFP usually involutes with age, therefore the appropriateness of its removal should be carefully evaluated in each patient, in order to avoid developing of a bony cheek later in life. 2 In the series, in case of hypertrophic BFP or resistant to aging involution, an intraoral lipectomy was performed with high patients' comfort and outcomes. Instead, in case of MM hypertrophy, the midface definition was performed with the injection of BTX, with similar results.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 It has been used for reconstructive purposes as early as 1977 and it has been removed with increasing frequency in aesthetic procedures. 3,4 Despite the multitude of clinical and aesthetic uses, the correct surgical indications for BFP removal have yet to be fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

Clinical significance of the buccal fat pad: how to determine the correct surgical indications based on preoperative analysis

et al. 2018

View full text Add to dashboard Cite

Background: Despite the multitude of clinical and aesthetic uses, the correct surgical indications for buccal fat pad (BFP) removal have yet to be fully elucidated. Although the procedure is widely performed and promoted for aesthetic purpose, literature lacks of studies accounting for a proper evaluation of patients undergoing BFP removal.Methods: Between 2012 and 2016 patients seeking an improvement of the malar contour by reduction of the submalar prominence have been visited at the Department of Plastic Surgery of the Institution. A preoperative MRI was requested in order to correctly identify the volume of the BFP and the presence of a masseter muscle (MM) hypertrophy.Results: According to clinical examination and the results of the preoperative imaging, patients were offered different treatment options: patients with BFP hypertrophy underwent BFP removal through an itraoral approach; patients with MM hypertrophy received injection of 50 UI of botulinum toxin (BTX). No complications were observed in the postoperative period and all patients were satisfied with the results.Conclusions: According to the experience, midface contouring procedures should take account of both surgeons’ experience, patients’ expectations and anatomical evaluation. As such, there is no given approach suitable for all cases. Suggested visual criteria, clinical examination and imaging analysis are useful in establishing patient’s condition and determining the appropriate methods of treatment to enhance the facial profile.

show abstract

Anatomy and imaging of the deep fat of the face

Cited by 81 publications

References 3 publications

Ct Anatomy of Buccal Fat Pad and Its Role in Volumetric Alterations of Face

Ct Anatomy of Buccal Fat Pad and Its Role in Volumetric Alterations of Face

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

Clinical significance of the buccal fat pad: how to determine the correct surgical indications based on preoperative analysis

Contact Info

Product

Resources

About