颧脂肪垫及其固定结构的解剖学研究

Anatomic Study of Malar Fat Pad and its Fixed Structure

目的研究颧脂肪垫和其固定结构的解剖,寻找新的面中部年轻化手术方法。方法对10具福尔马林浸泡过的头部尸体进行肉眼及显微镜下解剖,观察颧脂肪垫的分布、位置及与皮肤层和深部SMAS层的固定结构,应用B超测量24名自愿者颧脂肪垫厚度。结果颧脂肪垫为面中部皮下脂肪的一个增厚区域,它的范围外侧起自颧弓和颧骨体交界,内侧到达鼻唇沟,上界位于眼轮匝肌下缘,下界位于口角外下方,在老年尸体可达下颌缘,近似一个倒置的三角形。颧脂肪垫与皮肤层之间有三个由致密的细小纤维隔组成的区域紧密结合,其与深面的SMAS层之间也有三个纤维隔连接区域。颧隔将面中部皮下脂肪分隔为两部分,颧脂肪垫与颊脂体通过薄层的表情肌可以清楚地分开。对比研究中国北方青年和老年女性颧脂肪垫厚度,发现老年组在一些位置脂肪垫厚于青、中年组。结论颧脂肪垫周围有韧带和纤维隔起到固定作用,悬吊颧脂肪垫时应将颧隔上下的脂肪垫分别悬吊。老年人面部脂肪增多可能也是脂肪垫下垂和鼻唇沟加深的原因之一。

Objective To study the anatomic and fixed structure of malar fat pad to find a new method for facial rejuvenation. Methods 10 adult cadaver heads dipped into formalin were observed in aspects of the extension and location of the malar fat pad and their fixed structure with derma above and SMAS layer below with naked eyes and a microscope. The thickness of malar fat pad in 24 volunteers was measured with B type ultrasonic detector. Resuits The malar fat pad is an incrassate area of sub-dermal fat in mid - face. Its extension ranges from the junction of malar arch and malar bone body to nasolahial fold in lateral direction, and from the inferior margin of orbicularis oculi to lateral inferior part of the angle of mouth. In old cadaver the malar fat pad reaches the margin of mandible and forms an inverse triangle . There are 3 compact areas which consist of fine fibril septa between the fat pad and derma. And there are also 3 fibril septa between fat pad and SMAS layer. Malar fat pad can be distinguished distinctly from buccal fat pad by a layer of thin mimic muscle. Sub-dermal fat layer is divided into 2 parts by ma - lar septa. Thickness of malar fat pad of young , middle aged and old women in north China were measured. In comparing the results of 2 group ,it is found that thickness of malar fat pad of old women is thicker than that of middle aged and young women. Conclusion There are some ligaments and fibril septa fixing malar fat pad around. Two parts of fat pad above and below the malar septa should be suspended in mid - face rejuvenation operation respectively. An increase of volume of fat in old men may be one of reasons of fat pad ptosis and nasolahial fold deepening.