Newer Understanding of Specific Anatomic Targets in the Aging Face as Applied to Injectables

Summary: The identification of specific fat compartments of the face has greatly improved the plastic surgeon’s approach to facial rejuvenation. These superficial and deep compartments are discretely partitioned into multiple independent units by fascial barriers and undergo age-dependant volumetric changes. This knowledge has created a topographical map allowing for the direct and precise augmentation of those compartments that are deflated preferentially. These include the deep medial cheek, nasolabial, superficial middle, and lateral cheek compartments. Once this volume loss has been addressed, the overlying superficial musculoaponeurotic system and skin envelope can be treated to address laxity and bridge the compartments, creating a smooth cheek contour. Facial augmentation can be performed alone in the correct patient; however, it most often complements face-lifting. It is, therefore, important to have a thorough understanding of this anatomy and the changes that occur during aging.