Basic Consideration for Facial Aging: Analyses of the Superficial Musculoaponeurotic System Based on Anatomy.
Journal
Aesthetic surgery journal
ISSN: 1527-330X
Titre abrégé: Aesthet Surg J
Pays: England
ID NLM: 9707469
Informations de publication
Date de publication:
12 02 2021
12 02 2021
Historique:
pubmed:
12
11
2020
medline:
16
3
2021
entrez:
11
11
2020
Statut:
ppublish
Résumé
The superficial musculoaponeurotic system (SMAS) is an important structure to understand for face-lift surgeries. However, the detailed distribution and imaging findings of the SMAS have not been established yet. The aim of this study was to establish the accurate distribution and computed tomography (CT) imaging findings of the SMAS based on cadaveric studies. This study was designed in a 3-step procedure. First, 7 cadaver faces were utilized to understand the distribution and histology of the SMAS. Second, the SMAS findings from the cadaveric studies were compared with the CT images. Third, CT images were enrolled for the SMAS interpretation. In 7 cadaveric studies, the SMAS was observed as a subcutaneous fibro-membranous structure extending from the galea aponeurotica to the platysma muscle and laterally connected to the parotid fascia. On the medial side, it also connects with major and minor zygomatic muscles. The SMAS consisted of muscular fibers, collagen fibers, and elastic fibers histologically. Eighteen CT images (all females; age range, 21-82 years) showed the thin linear structures corresponding to the fibro-membranous structures in the cadaveric studies. CT density of the SMAS was similar with that of the muscle, and the SMAS was recognizable in all 18 subjects. The SMAS is a definite anatomical structure that can be demonstrated as a thin membranous structure on CT. This clinical application could be applicable to the development the cosmetic surgical procedures.
Sections du résumé
BACKGROUND
The superficial musculoaponeurotic system (SMAS) is an important structure to understand for face-lift surgeries. However, the detailed distribution and imaging findings of the SMAS have not been established yet.
OBJECTIVES
The aim of this study was to establish the accurate distribution and computed tomography (CT) imaging findings of the SMAS based on cadaveric studies.
METHODS
This study was designed in a 3-step procedure. First, 7 cadaver faces were utilized to understand the distribution and histology of the SMAS. Second, the SMAS findings from the cadaveric studies were compared with the CT images. Third, CT images were enrolled for the SMAS interpretation.
RESULTS
In 7 cadaveric studies, the SMAS was observed as a subcutaneous fibro-membranous structure extending from the galea aponeurotica to the platysma muscle and laterally connected to the parotid fascia. On the medial side, it also connects with major and minor zygomatic muscles. The SMAS consisted of muscular fibers, collagen fibers, and elastic fibers histologically. Eighteen CT images (all females; age range, 21-82 years) showed the thin linear structures corresponding to the fibro-membranous structures in the cadaveric studies. CT density of the SMAS was similar with that of the muscle, and the SMAS was recognizable in all 18 subjects.
CONCLUSIONS
The SMAS is a definite anatomical structure that can be demonstrated as a thin membranous structure on CT. This clinical application could be applicable to the development the cosmetic surgical procedures.
Identifiants
pubmed: 33175099
pii: 5974130
doi: 10.1093/asj/sjaa305
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
NP113-NP123Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 The Aesthetic Society. Reprints and permission: journals.permissions@oup.com.