颧脂肪垫的解剖结构

Anatomic structure of malar fat pad

目的:研究颧脂肪垫的解剖结构和固定结构,为寻找新的面中部年轻化手术方法打下基础.方法:对10具用40g/L甲醛浸泡过的尸体头部进行肉眼及显微镜下解剖,观察颧脂肪垫的位置、分布及与皮肤层和深部表浅肌肉腱膜系统(SMAS)层的固定结构.结果:发现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层之间同样有三个纤维隔连接.颧脂肪垫与颊脂体通过薄层的表情肌可以清楚地分开.结论:颧脂肪垫是面中部皮下层的重要结构,其周围有韧带和纤维隔起到固定的作用.通过悬吊颧脂肪垫结合传统的SMAS除皱术可以更好地改善面中部衰老的容貌.

AIM： To study the anatomic and fixed structures o~ the malar fat pad in order to find a new method for facial rejuvenation. METHODS： Ten adult cadaver heads which were dipped in formalin solution （40 g/L ） were observed in aspects of the extension and location of the malar fat pad and the fixed structure with derma above and SMAS layer below with naked eyes and a microscope. RESULTS： 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 nasolabial fold in lateral direction, 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 are 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 through a layer of thin mimic muscle. CONCLUSION： Malar fat pad is an important structure in the sub-dermal layer of mid-face. There are some ligaments and fibril septa which are the fixtures around malar fat pad. Aged appearance in mid-face can be improved through malar fat pad lifting plus traditional SMAS face lifting.