Anatomic Study of Malar Fat Pad and its Fixed Structure

Objective To study the anatomic and fixed structure of malar fat pad to find a new method for facial rejuvenation.Methods 10 adult cadaver heads dipped into formalin were observed in aspects of the extension and location of the malar fat pad and their fixed structure with derma above and SMAS layer below with naked eyes and a microscope.The thickness of malar fat pad in 24 volunteers was measured with B type ultrasonic detector.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,and 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 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 by a layer of thin mimic muscle.Sub-dermal fat layer is divided into 2 parts by ma-lar septa.Thickness of malar fat pad of young,middle aged and old women in north China were measured.In comparing the results of 2 group,it is found that thickness of malar fat pad of old women is thicker than that of middle aged and young women.Conclusion There are some ligaments and fibril septa fixing malar fat pad around.Two parts of fat pad above and below the malar septa should be suspended in mid-face rejuvenation operation respectively.An increase of volume of fat in old men may be one of reasons of fat pad ptosis and nasolabial fold deepening.