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The Midface Deep Fascia: The Missing Plane of The Infraorbital Region That Changes The Concept of Fascia Superficialis of The Face
Author(s) -
Andretto Amodeo Chiara,
Casasco Andrea,
Icaro Cornaglia Antonia,
Keller Gregory
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.542.1
Subject(s) - fascia , face (sociological concept) , anatomy , deep fascia , temporal fascia , medicine , orthodontics , social science , sociology
The superficialis fascia of the face, named “Superficial Musculo‐Aponeurotic System » (SMAS), is thought to be the investing layer of the facial mimetic muscles¹ A recent anatomical finding shows that in the midface² a deep fascia, connected to the superficial layer of the deep temporal fascia, exists. It covers the mimetic muscles of the infraorbital area with bony insertion, such as the zygomaticus major, minor, the levaetor labii superioris, the levator labii superioris alaeque nasi and the levator anguli oris muscle. Methods: 30 hemifaces have been dissected to study the relationship of this deep fascia with the superficialis fascia (Smas) and the mimetic muscles in the midface. Results: In all specimens the SMAS and the deep fascia of the infraorbital region fused at the level of the orbicularis oris muscle, only the orbicularis oculi muscle and the orbicularis oris muscle were part of the SMAS, the other mimetic muscles were covered by a deep fascial plane. Conclusions This study shows that the concept about the Smas as the investing layer of the mimetic muscles can't be considered valid anymore, not either the concept that it is the vessels and nerves carrying layer. These new observations carry important implications in both anatomy and facial plastic surgery.