PEER-REVIEW | INJECTABLES | between the infraorbitary and nasolabial fat.


Laterally, this compartment is bordered by the zygomaticus major muscle and the middle cheek fat. Infero-medially to the medial cheek fat is the nasolabial fat, which is positioned parallel to the nasolabial fold.


Nasolabial fat With an oblong form, it lies laterally to the nasal pyramid and parallel and cranially to the nasolabial fold. The orbicularis retaining ligament represents the superior border of this compartment. It borders supero-laterally with the medial cheek fat, infero-medially with the nasolabial fold. Its inferior part borders and overlaps the superior jowl fat.


Middle cheek fat Located laterally to the medial cheek fat, it is bordered superiorly by the zygomatic ligament. Above this compartment the ligament is thick and constitutes the McGregor patch. The middle cheek fat does not extend above the inferior margin of the zygomatic arch. Anteriorly it is bordered by the masseter ligament that begins inferiorly to the McGregor patch and descends vertically along the anterior border of the masseter muscle. The ligament arises from the fascia of the masseter muscle and inserts into the SMAS and the overlying dermis of the cheek. The middle cheek fat laterally borders with the lateral temporal-cheek fat. The parotid-masseter septum divides these two compartments. Caudally to the middle cheek fat we find the inferior jowl fat.


Figure 3 Sagittal section along the mid-pupillar line


Infraorbital fat (malar mound)


Orbicularis oculi muscle


Nasojugal crease


Above the orbicularis oculi muscle and SMAS plane lie the infraorbital fat (malar mound) and the medial cheek fat (in red). The zygomatic- cutaneous ligament separates these two compartments. Its attachment to the dermis creates the nasojugal crease. Under the orbicularis oculi muscle and SMAS plane are the medial SOOF and the deep medial cheek fat (in blue) that lie on the periosteal plane. The zygomatic-cutaneous ligament divides these compartments. The orbicularis retaining ligament borders superiorly the medial SOOF.


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Orbicularis retaining ligament


Medial SOOF


Zygomatic cutaneous ligament


Intraorbital fat


Lateral temporal-cheek fat Is the most lateral compartment of the cheek. This fat lies in direct contact with the parotid gland and connects the temporal fat to the cervical subcutaneous fat. The cheek section is firmly attached to the parotid fascia.


Superior jowl fat It is inferior to the nasolabial fat and it is lateral to the modiolus. Its lateral boundary is the middle-cheek fat.


Inferior jowl fat Located inferiorly to the middle-cheek fat and the superior jowl fat. Its medial boundary is the mandibular ligament and its posterior boundary is the lateral temporal-cheek fat. The inferior boundary is determined by the mandibular septum. The first three superficial fat compartments (infraorbital,


medial cheek, and nasolabial fat) are described as a unique anatomical structure: the malar fat pad. It has a triangular shape with the base parallel to the nasolabial fold and with the apex near the malar projection. The malar fat pad is loosely attached to the deep plane (SMAS), but it is firmly attached to the skin16


SMAS


Medial cheek fat


October 2015 | prime-journal.com


Deep medial cheek fat


. The malar fat pad is supported in its


location in youthful individuals by multiple fibroelastic fascial septa that extend through the fatty cheek mass originating from the underlying superficial fascia, which allows the mimetic muscles to attach to the overlying cutaneous dermis17


.


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