Some Anatomical Observations on Midface Aging and Long-Term Results of Surgical Treatment

Owsley, John Q.; Roberts, Christa

doi:10.1097/01.prs.0000293872.14916.bb

Cited by 55 publications

(33 citation statements)

References 16 publications

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“…Over time, this produces a redistribution of fat and flaccid skin. This explains why when the malar fat is lifted, the nasolabial fold improves dramatically (25). That is why we prefer to apply several different vectors of traction when treating the SMAS, starting at the malar area.…”

Section: Discussionmentioning

confidence: 99%

Short-Scar Facelift without Temporal Flap: A 10-year Experience

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Short-Scar Facelift without Temporal Flap: A 10-year Experience

et al. 2014

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“…SMAS was weakened over nasolabial fold where the thickest portions near the parotid region transits to the thinnest area and it was hard to find with naked eye. 16 Weakening of SMAS attachment in the tendon and muscles of the zygoma and skin explains inferior dislocation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anatomical alar band

Kim¹,

Kim²,

Yul³

et al. 2015

Journal of Korean Academy of Esthetic Dentistry

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연세대학교 치과대학 구강생물학교실, 3 연세대학교 치과대학 교정학교실Purpose: Due to the presence of various muscles around lips, variety of facial expression can be made and changes from aging process such as wrinkles can develop on the facial skin by the action of multiple muscles. In animals, skin and muscles are developed in the entire body. On contrast, they are well developed only in the face and just one is present in the neck and the palm. Alar band was defined as outer wrinkle formed by zygomaticus minor muscle, which is common in Koreans. This study aimed to investigate clinical prevalence of alar band. Materials & Methods: Subjects were chosen from 780 new patients who visited private clinic in Gyeonggi province for orthodontic treatment. Presence of alar band was examined from the smile extraoral photos. Correlation among skeletal form, lip protrusion, gender, and age were evaluated. Results: Prevalence of alar band was higher in women (27.9%) than in men (18.5%) with statistical significance (p<0.05). With respect to age, prevalence of alar band was 19.4% in age 0-9 y, 16.9% in age 10-19 y, 31.2% in age 20-29 y, 39.5% in age 30-39, 56.5% in age 40-49. Prevalence was gradually increased from patients in their 20s to patients in their 40s and statistical significance was found (p<0.001). Concerning SN_NP, prevalence was 26.2% in normodivergent facial type, 22.0% in hyperdivergent facial type, and 32.2% in hypodivergent facial type. Hypodivergent facial group had higher prevalence but statistical significance was not observed. Statistically significant difference was not found regarding upper lip. However, prevalence of the alar band was 26% in patients with normal lower lip, 14.7% in patients with pretruded lower lip, and 33.3% in retruded lower lip. The prevalence was higher in patients with retruded lower lip with statistical significance (p< 0.05). Conclusions: 27.8% on previous anatomical study and this study showed 27.8% prevalence of alar band in clinical smile photographs. Clinical photograph study showed that alar band was more prominent in women, older people, and people with retruded lips with statistical significance. This will provide valuable diagnostic information for esthetic consideration. (J Korean Acad Esthet Dent 2015;24(1):4-12)

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“…However, if the swelling in the malar mound region is primarily subdermal, then the presentation is known as malar festoons instead. These "malar bags" may also atrophy with age, resulting in the appearance of "festoons" of lax infraorbital malar skin that hang over the fixed line of orbitomalar septal insertion [11,14].…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

“…This also outlines the caudal margin of an elliptical portion of the superior lateral cheek fat [11]. The orbitomalar septum (Fig.…”

Section: Festoons and Malar Moundsmentioning

confidence: 99%

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The troublesome triad: festoons, malar mounds, and palpebral bags

Phoebe¹

2017

J Cosmet Med

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The ill-defined lid-cheek junction continues to be one of the most challenging regions for rejuvenation. Malar mounds, festoons or palpebral bags, may occur alone, or in combination, in the infraorbital area. These pathological variants are distinctly different and may contribute to patients' perception of their eyebags. Traditional lower blepharoplasty (fat repositioning/ removal) with skin adjustment alone may be insufficient in addressing all of these pathologies, and recurrence may occur. This literature review aims to look at current definitions and treatment of festoons, malar mounds, and palpebral bags in Asian blepharoplasty. A Medline literature search for articles with anatomic descriptions of malar mounds, palpebral bags and festoons, particularly in Asian eyelids, was performed. This was supplemented by a manual search of the references of articles obtained. The details of all of the different surgical options for eyelid rejuvenation are beyond the scope of this review article. Thus, only the basic concepts that illustrate the anatomical relationship and the natural progression of malar mounds, festoons, and palpebral bags will be discussed in this article. Some of the treatment options, both invasive and non-invasive, will also be reviewed. There is no singular treatment for malar mounds, festoons, and palpebral bags. Standard lower blepharoplasty with skin excision is ineffective to lift and re-drape malar mounds or festoons. Repositioning of the malar septum, on the other hand, allows for resolution of the edema (malar festoons) above its cutaneous insertion. A number of liposculpturing techniques to volumize deficient areas, such as fat repositioning (cheek, suborbicularis and descended malar fat pad) with lifting of the midface, can be beneficial to restore a smooth lid-cheek junction.Non-invasive techniques like laser resurfacing and Ultherapy ® (Ulthera, Inc., Meza, AZ, USA) may be useful in periorbital rejuvenation in selected cases.

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Some Anatomical Observations on Midface Aging and Long-Term Results of Surgical Treatment

Cited by 55 publications

References 16 publications

Short-Scar Facelift without Temporal Flap: A 10-year Experience

Short-Scar Facelift without Temporal Flap: A 10-year Experience

Prevalence of anatomical alar band

The troublesome triad: festoons, malar mounds, and palpebral bags

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