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Nasojugal fat pads

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Nasojugal fat pads make your face look puffier and more swollen, even if you are a skinny person. The condition worsens if you have dark circles around your eyes since they make the nasojugal fat pads look more prominent. Nasojugal fat pads make faces look tired all the time. It is cosmetic in the first place, but it may be a sign of a serious. Transconjunctival sub-orbicularis oculi fat (SOOF) pad lift blepharoplasty: a new technique for the effacement of nasojugal deformity Arch Facial Plast Surg . Jan-Mar 2000;2(1):16-21. doi: 10.1001/archfaci.2.1.16 Figure 1 - Nasojugal lines typically form in conjunction with other undereye cosmetic flaws such as nasojugal fat pads and lower eyelid puffiness. Why Do Nasojugal lines Affect Facial Aesthetic ? Nasojugal lines result from the deep depression between the eye and nose running from the eyelid's inner corner passing through the infraorbital.

L Pads - L Pad

  1. The sliding fat pad technique by the transconjunctival approach is a new variation of Loeb's technique that enables simultaneous correction of the lower-eyelid fat bags and the nasojugal and palpebromalar sulci, transposing the fat in the form of a flap through the arcus marginalis
  2. g 5 growing waves of skin at points of attachment, developing: • hooding along the eyes, • lower eyelid / cheek junction or tear trough / nasojugal fold • nasolabial fold, • lateral mouth commissure and marionette folds.
  3. (A) A 42-year-old woman with herniated fat pads, deficiency in the nasojugal groove tear trough area, and rhytids is shown preoperatively. (B) Two months after removal of fat pads after smoothing of nasojugal groove, fat grafting, and removal of orbital fat

The nasojugal groove (NJG) extends inferolaterally from the medial commissure to the midpupillary line. In some patients, the palpebromalar groove (PMG) is visible laterally to this point. Sometimes, the NJG and the PMG merge with age, forming a single continuous groove, which clearly marks the protrusion of orbital fat cranially, and the malar. During blepharoplasty, after removal of the orbital fat pads or repair of the herniated septum containing the fat pads, injection in the lower part of the attachment of the orbicularis muscle to the orbital rim has the potential for elevating the nasojugal groove without subdermal aberrations or bulges

What Are Nasojugal Lines? | QOVES Studio

The superficial fat pad (SFP) of the middle third of the face is exposed. Fig. 10.11 Anterior view of the deep fat pads (DFPs) of the middle third of the face: (1) deep medial cheek fat pad, (2) deep lateral cheek fat pad. Fig. 10.12 A. Left side of the face of a fresh cadaver specimen with exposed superficial fat pad (SFP).B In the young individual the transition between lower eyelid and cheek is imperceptible. The dividing line between these areas in older individuals is the nasojugal crease also called the nasojugal groove (term first used in 1961) or tear trough (term first used in 1969). It is an early sign of aging around the eyes, lending a fatigued and aged. We define fat repositioning as the subperiosteal repositioning of the medial and central lower lid herniated orbital fat into the nasojugal fold. The lateral orbital fat pad may be repositioned into the lateral inferior orbital region if needed Loeb was among the first to describe the advancement of the medial lower lid fat pad to recontour the nasojugal groove.5, 6 Shortly thereafter, Hamra published his description of the arcus marginalis release technique, in which he extended Loeb's concept to include advancement of all of the lower lid fat pads in an effort to conceal the. Note the deep nasojugal sulcus in a typical patient who is a candidate for a transconjunctival sub-orbicularis oculi fat pad lift blepharoplasty. Inferior Orbital Rim Zygomatic Muscles Orbicularis Oculi Malar Pad A B Figure 2. The relationship between the malar pad and the orbicularis oculi and zygomatic muscles (A)

What Are Nasojugal Fat Pads? QOVES Studi

  1. These fat pads are sandwiched between the orbital septum and lower lid retractors. In the horizontal plane, the inferior oblique muscle lies between the nasal and central pad, and the arcuate ligament (an extension of Lockwoods's ligament) separates the central and lateral fat pad ( Fig. 12.2 )
  2. In 1961, Loeb described the 'nasojugal groove'; the medial concavity between the eyelid border and cheek. He hypothesised the defect was due to volume loss of the medial and central fat pad, in addition to fixation of the orbital septum at the level of the inferomedial portion of arcus marginalis [1]
  3. Figure 1 - Puffy lower eyelid; not to be confused with nasojugal lines, nasojugal fat pads or eyelid ptosis.This flaw is only made more noticeable in those with contour depressions and hollow periocular (eye) regions
  4. The deep midfacial fat pads (suborbicular fat and deep medial fat) move to form any folds, particularly the nasojugal fold. This fold is a depression caused by the separation of the orbicular muscle from the eyelids and the levator labii superioris muscle, with anteroposterior regression of the globe of the eye
  5. imal decrease in the eyelid/cheek juncture. In this retrospective study of patients undergoing surgery at our clinic between 2000 and 2018, 92 were classified as Hester II and a transconjunctival.

Transconjunctival sub-orbicularis oculi fat (SOOF) pad

Treating Tear Trough Deformity: Transconjunctival Blepharoplasty with Fat Pad Repositioning and Fixation in the Intranasal Mucosa-18 Years' Experience Aesthetic Plast Surg . 2019 Jun;43(3):695-701. doi: 10.1007/s00266-019-01353-1 The infraorbital hollow (IOH) refers to the curvilinear or U-shaped depression under the eyes from the nasal bone to the outer corner of the eye and comprises three core elements: the 'tear trough' and nasojugal fold medially, and the palpebromalar groove laterally ( Fig. 16.1 ). Although the terms 'tear trough' and 'nasojugal fold. The Clinical Problem: Prominent Bulging Suborbicularis Oculi Fat Pad and Retro-Orbicularis Oculi Fat Pad ( Fig. 9.1 ) The aging lower eyelid can be a complex and difficult problem to improve aesthetically. There is considerable risk of over-resection of both fat and skin, with consequent pull-down ectropion and permanent hollowness. An anatomic understanding of th

Transconjunctival Sub-Orbicularis Oculi Fat (SOOF) Pad Lift Blepharoplasty. A New Technique for the Effacement of Nasojugal Deformity. M. Sean Freeman; M. Sean Freeman. Corresponding author: M. Sean Freeman, MD, Plastic Surgery and Laser Center, 1600 E Third St, Charlotte, NC 28204 Correction of iatrogenic and congenital depressions of the septal portion of the lower lid with free fat grafts has had good long- and short-term results. A new technique for filling deep nasojugal depressions by sliding fat from the mesial and inner fat pads has also been satisfying Many techniques have been described in the literature to improve nasojugal deformity, also known as tear trough deformity. 1-4 As is typically the case when there are several different techniques to improve the same problem, none of these approaches has stood the test of time and become favored. The transconjunctival sub-orbicularis oculi fat (SOOF) pad lift blepharoplasty is a new approach.

What Are Nasojugal Lines? QOVES Studi

Abstract. B ackground: Pronounced nasojugal sulcus (tear trough deformity) is a frequent and distressing symptom in aesthetic palpebral surgery. The sliding fat technique using the transcutaneous or transconjunctival approach has proven to be considerably useful in patients with clinically evident fat bags Increasing age brings about lipoatrophy, bone reabsorption and laxity of ageing membranes. This, in turn, leads to a pseudo herniation of facial fat over the zygoma and maxilla. As the fat pad migrates downwards and more medially, skin loses its full supporting framework. It sags and collects, without structure, around the eyes, cheeks, and mouth The depressed irregularities are represented by the cresent-shaped hollow at the lid-cheek junction, the accentuated nasojugal groove, and the deepening nasolabial line. Repositioning of the ptotic malar fat pad, among other elements of meloplasty, represents a key procedure M any techniques have been described in the literature to improve nasojugal deformity, also known as tear trough deformity. As is typically the case when there are several different techniques to improve the same problem, none of these approaches has stood the test of time and become favored. The transconjunctival sub- orbicularis oculi fat (SOOF) pad lift blepharoplasty is a new approach. Key to this understanding is the so-called malar fat pad, which he says is a misnomer: It is not fat, but fibroadipose tissue. Objectives of midface facelifting include elevating the corners of the mouth, restoring the prominence of the cheek (particularly along the zygoma), improving the nasojugal folds and elevating the jowls, Dr. Vasconez.

Sliding Fat Pad Technique with Use of the

  1. These fat pads can be either conservatively trimmed or repositioned along the nasojugal groove. The nasojugal groove is a gulley that forms with aging which extends from the medial eyelid across the lower eyelid and upper cheek junction
  2. imal decrease in the eyelid/cheek juncture. MATERIALS AND METHODS: In this retrospective study of patients undergoing surgery at our clinic between 2000 and 2018, 92 were classified as Hester II and a.
  3. Fat pads 41: There are three lower pads: medial, central, and lateral. They are found behind the septum. In the management of tear trough deformity, the projection of the medial and central fat—which are separated by the inferior oblique muscle—is important. Orbitomalar ligamen
  4. In short, weakening of certain structures of the eye allow the surrounding fat to protrude (or herniate) and push against these weakened structures. This pseudoherniation of the orbital fat pads is a main contributor to under eye bags, which can also create or exacerbate the appearance of the nasojugal fold (aka, tear-trough deformity)
  5. Answer: Bellafill results around eye have had a poor outcome. These results are from poor injection technique. It is not related to fat pad displacement. What you are seen is a collection of filler in a superficial plane. These aren't your final results because that will take about 6 months to appreciate
  6. Volume loss of the orbital rim contributes to the development of the nasojugal groove. Because there is no dissectible anatomic region beneath the orbicularis oculi muscle in that area, it is advisable to correct the nasojugal deformity by injecting subdermally or within the orbicularis oculi muscle fibers. Depletion of midfacial fat pads.
Transconjunctival Sub–Orbicularis Oculi Fat (SOOF) Pad

Fat repositioning is defined as the subperiosteal repositioning of the medial and central lower lid herniated orbital fat into the nasojugal fold. The lateral orbital fat pad may be repositioned into the lateral inferior orbital region if needed. Fig. 1. Frontal view of a female patient following traditional transconjunctival removal of lower. In 24 of 34 patients, results were rated excellent Correction of Nasojugal Groove With Tunnelled Fat Graft Volume 29 • Number 3 • May/June 2009 • 195 The amount of tissue necessary for the correction of the nasojugal groove is minimal (approximately 0.25 cm3) but requires precise placement Nasojugal fold; Malar or zygomatic fold; Lower fat pads and septal weakness; Early festoons; Skeletonization of orbital rim with orbitomalar ligament lengthening; Solar elastosis, loss of facial fat, cheek rhytid They are also called nasojugal bands. Zygomatico cutaneous ligaments lie over the frontal cheekbone from superomedial to inferiolateral directions. This ligament divides the superficial and deep malar fat pad to top and bottom. With age, the lower deep malar fat pad atrophies and sags, causing an indentation In 2013, Yang et al. reported that atrophy of the malar fat pad makes GIR and HIR more obvious with age. He found that the superior border of the malar fat pad in elderly specimens was lower than in younger specimens, and the thickness and volume of those malar fat pads were visibly less than in young specimens

The nasojugal groove, commonly known as the tear trough, is a cutaneous groove that extends inferolaterally from the medial canthus to medial pupillary line. The technique of Huang , in which the capsulopalpebral fascia, orbital septum and fat pads are dissected beyond the arcus marginalis to cover the tear trough and lid-cheek junction. From an anatomic standpoint, the nasojugal groove is caused by descend (ptosis) of the malar fat pad (cheek) as we continue to age. My patients always come asking to have the groove injected with a filler, and I have to tell them the problem is not loss of volume at the groove, but rather descend or ptosis of the cheek it self Technically speaking, fat repositioning is defined as the subperiosteal repositioning of the medial and central lower lid herniated orbital fat into the nasojugal fold. In simple words, bulging fat within the eyeball sockets are placed in places where there is hollowness or sunkenness. The lateral orbital fat pad could be repositioned into the.

Loeb 8 first designated the nasojugal groove; others, including Flowers, Lambros, and Hirmand, have subsequently defined the tear trough. 9-11 The herniation of lower lid fat pads accentuates the tear trough, which appears as a concavity in the medial periorbital area . Both nonsurgical and surgical options have been described to provide a. The fat was injected with 1 mL syringes in 0.1-mL increments in multiple planes from the periosteum up to the superficial subcutaneous tissue. Fat was transferred to the temporal and brow areas, nasojugal grooves, cheek fat pads, buccal regions, nasolabial folds, labiomandibular folds, and prejowl areas Retrognathia, previously known as Mandibular Retrognathia, or Jaw recession is described as a small sized mandible associated with with chin recession ( 1 ). Mandibular Recession is a multi-factorial condition caused by genetic, epigenetic, and environmental factors ( 2 ). Genetic retrognathia can be evaluated prenatally, through a detailed USG The outlines of the three fat pads are marked, and a topographical marking is made over the individual pads, together with notes if one pad or side needs more or less attention. Careful attention is paid to the nasojugal groove and the malar groove

Fat pads near lip? What is this? And how do I get rid of

Transposing native eyelid fat to the nasojugal groove (tear trough) has become a standard adjunct to lower blepharoplasty in the appropriate patient. 1 First described in 1981, 2 the technique has evolved over time. Fat has been repositioned through a transcutaneous 3,4 or a transconjunctival 5,6 access and into the supraperiosteal 7,8 or the subperiosteal plane, 1,5,6 depending on the surgeon. Mobilizing fat over the rim enhances the coverage of the orbital bony rim serving to augment the projection of the rim and camouflage some of the prominence of the globes. 3. Prominent nasojugal groove. Mobilized orbital fat below the attachment of the levator labii superioris alaeque nasi will help to efface the contour of this depression. 4 The nasojugal and malar folds represent the junctions of the thin eyelid skin to the thicker skin of the cheek. In addition, the angular artery and vein will generally be located in the nasojugal fold. The brow fat pad contributes to the sexual variation in brow anatomy; in masculine brows, the brow fat pad is more prominent and extends.

Using 0.5 ml Lyft Dermal Filler per cheek and 0.5 ml Restylane Dermal Filler per Tear Trough. Post video and picture taken 3 weeks after treatment. Results l.. The term lower blepharoplasty includes a collection of surgical techniques that aims to improve the appearance of the lower eyelids. Historically, lower blepharoplasty was a reductive procedure in which skin and/or fat was removed in order to reduce lower eyelid wrinkles, skin redundancy, and fat bulges With age the fat pad descends and loses volume, which creates fullness and deepening of the nasolabial sulcus. 51. Deep compartments 52. These include the sub- orbicularis oculi and oris, buccal fat pads, deep medial cheek fat, and lateral deep cheek compartment. 53. *The deep medialcheek fat is stained with methylene blue Thin vermilion is one of the earliest signs of ageing. The vermilion is the area, margin, or zone between the lip and the adjacent skin. It is the area where women apply lipsticks. Cosmetic problems such as loss of normal volume, wrinkles, and fine lines, and dryness usually affect this area in addition to the entire lip. It even can appear early at the age of 28

Volume Correction for Nasojugal Groove With Blepharoplasty

Chapter 11 Filler Injection of the Nasojugal Groove and

DEFINITIONS AND ANATOMIC STUDIES OF GIR AND HIR. GIR refers to a fine indentation located around the orbital rim at the lid-cheek junction, and has several names, including nasojugal groove (or fold), tear trough deformity, and palpebromalar groove [1,2,4-11].In contrast, HIR refers to a relatively broad depression in the infraorbital area, including the medial and central cheek region, and an. The bulging of descended orbital fat and the prominence of the orbital rim after descent of the malar fat pad all contribute to increase nasojugal groove [29,30]. Malcolm Paul [1] described tear trough deformity as a groove located at orbital rim base. Volume loss allows the surface anatomy to appear as a triangular confluence of inferomedial.

Nasojugal fold (tear trough depression) Depression between the rim of the orbital bone and the nasal sidewall Prominent transitions between cheek fat pads and flattening of the malar prominence mark the deflated midface; the heart-shaped face of youth becomes distinctly pear shaped [10, 29, 31] Lower blepharoplasty is intended for patients who have observed wrinkly and/or puffy lower eyelids. Much like the face and upper eyelid, the aging lower eyelid is plagued by an accumulation of redundant skin and loosened underlying eyelid muscles, resulting in herniation of fat pockets; this herniation can result in unsightly puffiness of the lower eyelids called festoons The facial aging process causes multiple changes to the face and neck, including an increase in lines/wrinkles, darkening under the eyes, sagging of the skin, jowls, etc. There are multiple causes, including loss and migration of fat pads, stretching of ligaments, repeated muscle activity, loss of skin elasticity, bony changes, etc Shop Devices, Apparel, Books, Music & More. Free UK Delivery on Eligible Order essed irregularities are represented by the cresent-shaped hollow at the lid-cheek junction, the accentuated nasojugal groove, and the deepening nasolabial line. Repositioning of the ptotic malar fat pad, among other elements of meloplasty, represents a key procedure. In this study, the malar fat pad has been defined as a fan-shaped structure by external anatomic landmarks that correlate.

Lower lid blepharoplasty with fat grafts for correction of

  1. September 21, 2015. Answer: Nasojugal groove. It sounds like you are talking about buccal fat pad removal, usually performed through incisions inside the mouth. It is a fairly straight forward procedure, but indications are limited. Seek the advice of a board certified plastic surgeon in our area
  2. The fat pads were transferred and blended well with midface fat (Fig. 3D). The fat pads can be transposed individually or as a unit. Redundant fat tissue was trimmed. Last, the mucosal margins were approximated properly and left unsutured. the nasojugal fold, also known as the tear trough, remained. 15 To sufficiently correct the tear.
  3. imal or no eyelid bags. However, patients with excess skin and herniated fat pads are better candidates for a lower blepharoplasty
  4. nasojugal groove due to attachments inferomedially. Fat pads The upper periorbital area contains the preaponeurotic fat pad, preseptal fat pad, and galea fat pad or retro-orbicularis oculi fat (ROOF) pad. In periorbital aging, the preseptal and the ROOF fat descends and ma
  5. Protruding fat pads underneath the eyeballs form what are commonly-called lower eye bags (pseudoherniation), giving the eyes a tired, unrested look. Combined with the descent of the midface fat pad, a hollow groove (nasojugal groove) then forms between the lower eye bag and the descended midface fat pad
  6. e the efficacy of platelet-rich plasma (PRP) as a cosmetic facial injectable filler to treat tear troughs deformities secondary to volume loss and skin laxity in the infra-orbital region. Patients will receive injections of PRP on the left side, and PRP with A VectraH1 3D camera will be used.
  7. Lower eyelid fat pads can then be removed or repositioned, tailored to the patient's cosmetic needs. Customized treatment of the middle anatomic layers of the eyelid is critical. This layer is often released surgically, and spacer materials, usually composed of processed collagen, are often used to provide vertical support to the eyelid.

Chapter 10 Filler Injection of the Malar and Zygomatic

The formation of the tear trough deformity is often one of the first signs of aging around the eyes. The concavity in the nasojugal groove is often associated with apparent fat herniation above or it may present independently. There is individual variation in depth and morphology of the tear trough and periorbital hollows along the rim 9. Nasojugal fold 10. Malar or zygomatic fold 11. Lower fat pads and septal weakness 12. Early festoons 13. Skeletonization of orbital rim with orbitomalar ligament lengthening 14. Solar elastosis, loss of facial fat, cheek rhytids 15. Cheek flattenin pad. Sometimes, only one or two of the three fat pads need to be repositioned, depending on the areas of prominence of the nasojugal groove. Of note, in patients who have an enormous amount of pseudoherniating fat, one would have to excise some of the fat that is not needed as a cushion between the skin and the periosteum. Once repositioned. From this entry point the cannula is manoeuvred onto the pre-periosteal layer towards the deep medial fat pad. This is visualised as an area bounded medially where the nasal bone joins the maxilla, superiorly the medial canthus, laterally the nasojugal grove (lateral margin of the nasolabial fat pad) and inferiorly the alar tragal line

The nasojugal groove occurs in the infraorbital region and corresponds with the inferior border of the orbicularis oculi muscle. 12 The nasojugal groove is located slightly inferior and oblique to the tear Additional anatomical considerations of the aging face include herniation of the intraorbital fat, descent of infraorbital fat pads,. Visual presence of the infraorbital rim, nasojugal folds, malar fat pad, or cheek festoons • Presence and position of the supratarsal fold (lid crease) • Position and presence of the fat pads (gentle globe pressure to accentuate pseudo fat herniation) • Eyelid excursion with opening and closing of the eyelids (check for ptosis)

Rejuvenation of the upper face | PRIME Journal

Nasojugal crease, tear trough deformity, nasojugal groove

  1. (laterally) and the nasojugal fold (medially). Volume loss in the infraorbital area also leads to the emergence of for-merly concealed infraorbital fat pads (palpebral bags) and accentuation of the tear-trough depression, running obliquely from the lateral nose at the level of the medial canthus down to the anterior malar cheek below the mid
  2. While the above described the fat pads within the upper eyelid, the lower eyelid fat pads are slightly different in structure. The inferior oblique muscle separates the central fat pad from the dinner medial fat pad. There is a small amount of fat that lies in front of the inferior oblique muscle as well
  3. istration for improving the appearance of nasolabial folds. However, the treatment requires three sessions every 3-6 weeks. It is known that the skin overlying the nasojugal groove is thinner, and the wrinkle is generally shallower than nasolabial folds
  4. g the tear trough. It runs inferiorly and medially from the outer canthus toward the inferior aspect of the nasojugal and malar folds. retroseptal fat pads, and.
  5. The nasal fat pad contains fat that has a distinctly white color when compared to the other fat compartments of the eyelid. The lower eyelid contains three postseptal fat compartments. These are the nasal, central, and lateral fat pads. This anatomic area also referred to as the nasojugal groove, is created by the attachment of the orbital.
  6. exposed and hollow. (Right) The supefficial subciliary cheek lift elevates the malar fat pad and cheekpad complex and effaces the nasojugal groove by lifting the cheekpad complex. Pretarsat Orbicularis Preservation in flap fat ped oculi Sub Zygomaticus major nerve branches 01 The pretarsal strip of orbicularis oculi mus
CRITOE Archives - thebluntdissectionsay Goodbye to Smile Lines (Nasolabial Folds

The deep and superficial fat pads together with the temporalis muscle make up the concave appearance of the temple region. As the individual ages the fat pads tend to the zygomatic eminence (laterally) and the nasojugal fold (medially). The formation of crow's feet or rhytids at the lateral aspect of the eyes is as in the forehead region. Restoring position and volume to the malar fat pad enhances volume and fills the nasojugal and tear trough deformity that is apparent with facial fat descent and deflation associated with aging. By filling above the boney layer of the midface, a full lower eyelid is reestablished

Blepharoplasty Beverly Hills Eyelid Surgery Los Angele

As the face ages, it experiences fat loss in the lateral cheek area, exaggerating the appear-ance of the nasojugal groove. In addition to soft tissue and facial volume loss, there is resorption of bone; so much so that the ocular orbit actually becomes larger in old age. Finally, along with the atrophy of muscle, fat and bone, the patien There is improvement in the nasojugal region and in malar fat position, tear-trough deformity, and jowls. A, Anteroposterior view. B, Left oblique view. C, Left lateral view. Figure 6. Preoperative photographs of a second patient. A, Anteroposterior view. The anatomy of the aging malar fat pad suggests that,. The nasojugal fold runs inferiorly and laterally from the inner canthal region along the depression of separation of the orbicularis oculi and the levator labii superioris, forming the tear trough. The medial fat pad contains many plural divisions: the medial superior fat pad and medial inferior fat pad, of which half are delineated by.

The periosteal pulley technique for orbital fat

Injecting fat into the upper eyelid sulcus will create fullness, while making the redundant upper eyelid skin taut. In the lower eyelid, fat injections can diminish hollowing, or potentially, even out the valleys between the pseudoherniated fat pads. This fat contouring will eliminate the double bubble and create a more youthful appearance Similar to the nasojugal fold is another fold of skin that is evident in the outer aspect of the eyeball. This is called the malar fold and runs from the outer aspect towards the nasojugal fold. Fat Pads. There are a number of different fat pads that are present within and around the eyelid. One layer of fat called the pre-aponeurotic fat. Post-septal infraorbital fat pads: there are small medial (nasal), large central, and small lateral (temporal). The fat in the medial compartment is classically lighter in color and denser than the fat of the other compartments. which contributes to the formation of the nasojugal groove (tear trough). The lateral orbicularis is secured to. The suborbicularis oculi fat (SOOF) is a peri-orbital fat pad similar to the retro-orbicularis oculi fat (ROOF) pad in the brow.14 15 Anato-mists regard it as a deeper part of the malar fat pad which is mainly anterior to the mimetic muscles zygomaticus major and levator labii superioris.15 16 With age, there is a gradua The lower eyelid muscle is called the orbicularis oculi muscle and it spans from the medial to the lateral extent of the eyelid and helps close the eye. The orbital septum is a lining in the muscle that acts as a suspender and holds the fat pads in the socket of the orbit. Finally, the orbital fat pad act like sponges that mimic shock absorbers.

brow, the nasojugal fold, the malar and buccal fat pads, the lat-eral lip commissures, and the perioral region, including the pre-jowl sulcus, all restore youthful facial contour and harmony. An important advance in technique is the subdermal rather than the intradermal injection plane. RESULTS. Instant facial sculpting giving a brow-lift. Also known as the nasojugal groove, the tear trough is a depression extending infero-laterally from the medial canthus. It is demarcated superiorly by the infraorbital fat protuberance. The inferior border is formed by the skin of the upper cheek, suborbicularis oculi fat, and portions of the malar fat pad. 3 A selective hypertrophy of the of the cheek pad fat also complements the ptosis leading to midface aging changes. The ptotic hypertrophied cheek fat needs to be contoured as the facial muscles hardly show changes over age. Pre procedure half lateral view of a 42 year lady with deep nasojugal and nasolabial folds A safer, more natural and more be perpendicular to these folds to restore the malar fat pad at its original location (Fig. 1). The aging process of the periorbital contour is Publication presented at the meeting of the Societe Franc- caused largely by the action of the malar part of the aise des Chirurgiens Esthetiques et Plasticiens 23 June.