Changes in the Layers of the Temple During Pinch Manipulation: Implications for Thread Lifting

Abstract

BACKGROUND During minimally invasive aesthetic procedures, the skin is often pinched to facilitate filler injection or thread insertion into the desired layer. However, little is known about changes in the facial layers during pinch manipulation. OBJECTIVE To determine which layer of the temple is lifted during pinching and whether the artery and the nerve are affected by pinching. MATERIALS AND METHODS At 11 sites on 3 fresh Korean cadavers, the skin of the temple was pinched gently or deeply, and the skin pulled up was cut at the bottom. The exposed areas were grossly and histologically examined. RESULTS With gentle pinching, the subcutaneous fat and superficial temporal fascia (STF) layer were separated, and the fat was removed with the skin. The superficial temporal artery and temporal branches of the facial nerve were intact. With deep pinching, the STF was separated from the deep temporal fascia and lifted with the skin. CONCLUSION When thread lifting is performed, deep pinching is helpful for anchoring thread to the temporal fascia, whereas gentle pinching helps to insert thread into the safe subcutaneous fat layer, where no significant blood vessels or nerves are present.

Pinch anatomy: An injection guide for temple filler injections

“…Knowing the precise location and correct depth of major blood vessels, based on facial surface anatomy, is necessary for safe and effective filler injections. However, pinching with the nondominant hand during filler injection leads to some distortion in the anatomy of the tissue 3 . The impact of pinching on tissue anatomy is now being studied as pinch anatomy 1,2 and its implications during filler injections need to be emphasized.…”

“…The anatomy of tissue layers during pinching, known as pinch anatomy, becomes distorted from their natural appearance, both externally and internally. 3 In understanding the concept of pinch anatomy, it is essential to know the terms such as "pinch," "gliding plane," and "deep pinch" or "pinch and pull". A pinch can be described as a maneuver using the thumb and adjoining fingers to hold the tissue layers as a fold.…”

“…However, pinching with the nondominant hand during filler injection leads to some distortion in the anatomy of the tissue. 3 The impact of pinching on tissue anatomy is now being studied as pinch anatomy 1,2 and its implications during filler injections need to be emphasized.…”

“…Commonly, clinicians try to perform filler injections with their dominant hand while pinching and pulling the skin fold with their nondominant hand. The anatomy of tissue layers during pinching, known as pinch anatomy, becomes distorted from their natural appearance, both externally and internally 3 . In understanding the concept of pinch anatomy, it is essential to know the terms such as “pinch,” “gliding plane,” and “deep pinch” or “pinch and pull”.…”

Pinch Anatomy of Forehead: An Injection Guide for Forehead Filler Treatment

“…Commonly, clinicians perform filler injections with their dominant hand while pinching and pulling the skin fold with their non-dominant hand. During pinching, the anatomy of tissue layers, known as 'Pinch Anatomy,' becomes different from their natural appearance externally and internally 5 . While the external changes caused by pinching on the skin are visible on the skin surface, the injectors should be aware of the changes caused by these deformational forces in the deeper tissue layers.…”