A Volumetric Analysis of Soft-Tissue Changes in the Aging Midface Using High-Resolution MRI: Implications for Facial Rejuvenation

Abstract

The present study indicates that ptosis alone does not account for the changes observed in the aging midface. Selective hypertrophy of the upper portion of the cheek fat pad was also observed. The mimetic muscles, on the other hand, showed no significant differences with aging. To attain maximum precision in facial rejuvenation, these data suggest that after suspension of the ptotic cheek fat pad, each patient should be evaluated for excess bulk in the upper portion of the cheek fat pad. If excess bulk is present, patients may benefit further from selective reduction directed to the upper portion of the cheek fat pad, remaining superficial to the mimetic muscles of the 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

“…[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.…”

Perception of Age, Attractiveness, and Tiredness After Isolated and Combined Facial Subunit Aging

“…Indeed, according to Gierloff et al, as the face ages, there is an inferior migration of the midfacial fat compartment [23]. Midface volume changes have been described using MRI, topography, and photography [24][25][26]. We also found that lower lid fat herniation and upper eyelid ptosis make the subject appear most tired.…”

An analysis of Asian midfacial fat thickness according to age group using computed tomography

“…In addition, Gosain and colleagues revealed that the cheek fat pad is thickened and augmented in the elderly than in young subjects using 3D volumetric analysis of the facial magnetic resonance image. 17 In addition, this study revealed that there was a site specificity in midfacial fat thickening with aging. In an elderly subject's face, the infraorbital area (corresponding to the IO-lat and the IO-med) and the nasojugal area (NJsup, NJ-mid, and NJ-inf) are relatively elevated compared with the adjacent area (MC-lat and the MC-med: mid cheek depression).…”