Commentary on: Defining the Fat Compartments in the Neck: A Cadaver Study

Larson et al1 are to be congratulated both for their novel study, “Defining the Fat Compartments of the Neck: A Cadaver Study,” and for the effort required to investigate the cervical adipose tissues. The authors defined several new adipose compartments and concluded that, in most individuals, superficial adipose tissues usually are of a greater volume than intermediate (subplatysmal) fat. They thus provided a rationale for modifying superficial adipose tissues during routine cervicoplasty.1,2 The authors performed a prospective, nonrandomized study on fresh cadavers to determine relative volumes of cervical adipose tissues. They defined 3 initial layers and further compartmentalized these layers by injecting methylene blue dye. The study number indicates n = 10, although n = 20 could have been applied for all lateral compartments because cervical adipose tissue is not always symmetrical in volume. The Biomaterials Reporting for Improved Study Quality (BRISQ) study suggests 3 tiers of information that help make any study dealing with human biomaterial more easily reproducible and add greater value and scientific validity.3 The authors defined most of the tier 1 suggestions, including age (all >64 years), sex, and technique. Pathological diagnoses—in this case, the presence or absence of obesity assessed by body mass index (BMI)—were not available, as the authors note. Techniques of tissue acquisition and staining, along with staining duration and means of preservation, were clearly indicated, making it possible for another group to repeat and validate these findings. The use of postmortem tissue, although a more tedious method for volume study compared with retrospective noninvasive imaging, yields more information and is valid because each specimen acts as its own control: relative rather than absolute volumes are measured and compared. Thus, the cadaver's degree of hydration does not negate the results. The authors defined the superficial cervical adipose layer …