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09-05-2024 | Original Articles

Understanding the Interplay Between Skin, Fascia, and Muscles of the Midface in Facial Aging

Authors: Konstantin Frank, Nicholas Moellhoff, Nina Engerer, Kai O. Kaye, Michael Alfertshofer, Robert H. Gotkin, Samuel Kassirer, Charlotte Weinmann, Gabriela Casabona, Sebastian Cotofana

Published in: Aesthetic Plastic Surgery

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Abstract

Background

Surgical, minimally-invasive, and non-invasive aesthetic procedures try to ameliorate the signs of facial aging, but also focus on enhancing various individual features of beauty in each patient. Herein, the midface plays a central role due to its location but also its importance for the aesthetic perception and facial expression.

Objective

To date, no study has investigated the interplay between facial muscles and its connecting subdermal architecture during facial aging to provide a more comprehensive understanding of the middle face.

Materials and Methods

A total of 76 subjects, consisting of 30 males (39.5%) and 46 females (60.5%) with a mean age of 42.2 (18.7) years [range 19–80] and a mean BMI of 24.6 (3.7) kg/m2 [range 18–35], were enrolled in this investigation. Cutometry (skin aging), 3D skin displacement analyses (subdermal connective tissue aging), and sEMG (muscle aging) analyses were utilized.

Results

The results revealed that overall skin firmness increased, and skin elasticity decreased (p < 0.001), sEMG signal of the investigated muscles decreased (p < 0.001), whereas midfacial mobility remained unaltered (p = 0.722).

Conclusion

The results of this study indicate that midfacial aging is a measurable effect when utilizing individual measurement modalities for assessing skin, subdermal fascia, and midfacial muscles. The function of midfacial muscles revealed a potential threshold effect, which is not reached during midfacial aging due to the unchanged soft tissue mobility at older age. However, to understand its clinical presentation all midfacial soft tissues need to be factored in and a holistic picture needs to be created.

No Level Assigned

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Literature
3.
go back to reference Frank K, Weitgasser L, Redka-Swoboda W, Reumann S, Schenck T, Cotofana S (2014) The neurobiology of facial recognition: a neuroanatomical review of the literature. Kosmetische Medizin 35(6) Frank K, Weitgasser L, Redka-Swoboda W, Reumann S, Schenck T, Cotofana S (2014) The neurobiology of facial recognition: a neuroanatomical review of the literature. Kosmetische Medizin 35(6)
Metadata
Title
Understanding the Interplay Between Skin, Fascia, and Muscles of the Midface in Facial Aging
Authors
Konstantin Frank
Nicholas Moellhoff
Nina Engerer
Kai O. Kaye
Michael Alfertshofer
Robert H. Gotkin
Samuel Kassirer
Charlotte Weinmann
Gabriela Casabona
Sebastian Cotofana
Publication date
09-05-2024
Publisher
Springer US
Published in
Aesthetic Plastic Surgery
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-024-04070-6