https://doi.org/10.4081/ejh.2024.3912
Histological analysis of the dermal and hypodermal layers of the face and correlation with high-frequency 24 MHz ultrasonography and elastosonography
Submitted: 10 November 2023
Accepted: 22 December 2023
Published: 12 April 2024
Accepted: 22 December 2023
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Knowledge of the structure of the face is of fundamental importance. In fact, the face is treated in many areas of medicine, from dermatology, to maxillofacial surgery, to otorhinolaryngology, to ophthalmology, etc. and anti-aging aesthetic treatments, and those for the resolution of blemishes are on the increase. For ethical reasons it is not possible to take biopsy samples for facial analysis in the aesthetic field. The main aim of this study was to demonstrate that a high-resolution bimodal ultrasound examination, combined with elastosonography, could be a valid tool for pre-treatment morphological evaluation. To achieve this goal, skin samples were taken from the forehead, zygomatic area, nasolabial fold, upper and lower lip from cadavers to histologically characterize their structure. Subsequently, these same areas were evaluated in vivo using conventional B-mode ultrasound with a 24 MHz high-frequency probe, and elastosonography. The data obtained with the different techniques were compared, in order to state that modern ultrasound techniques can provide similar histological information. The analysis showed that the superficial hypodermis presented a different shape and structure in the different areas, with the exception of the areas of the upper and lower lip, which appeared similar. With aging, the forehead and zygomatic area showed a volumetric increase in the superficial hypodermic layer, while the lip showed non-structural changes. The morphology of the nasolabial fold remained unchanged. When it is not possible to perform histological investigations on the face, to understand its characteristics and dynamics, ultrasound with a 24 MHz probe would seem to be the most suitable method, while elastosonography could be a valid method for evaluating the stiffness of the structural components.
Kruglikov I, Trujillo O, Kristen Q, Isac K, Zorko J, Fam M, et al. The facial adipose tissue: a revision. Facial Plast Surg 2016;32:671-82.
DOI: https://doi.org/10.1055/s-0036-1596046
Rohrich RJ, Pessa JE, Ristow B. The youthful cheek and the deep medial fat compartment. Plast Reconstr Surg 2008;121:2107-12.
DOI: https://doi.org/10.1097/PRS.0b013e31817123c6
Wan D, Amirlak B, Giessler P, Rasko Y, Rohrich RJ, Yuan C, et al. The differing adipocyte morphologies of deep versus superficial midfacial fat compartments: a cadaveric study. Plast Reconstr Surg 2014;133:615e-22e.
DOI: https://doi.org/10.1097/PRS.0000000000000100
Wan D, Amirlak B, Rohrich R, Davis K. The clinical importance of the fat compartments in midfacial aging. Plast Reconstr Surg Glob Open 2014;1:e92.
DOI: https://doi.org/10.1097/GOX.0000000000000035
Stuzin JM, Baker TJ, Gordon HL. The relationship of the superficial and deep facial fascias: relevance to rhytidectomy and aging. Plast Reconstr Surg 1992;89:441-51.
DOI: https://doi.org/10.1097/00006534-199203000-00007
Bertossi D, Bernardi P, Benati D, Ruffoli M, Sbarbati A, Nocini P. Classification of fat pad of the third medium of the face. Aesth Med 2015;1:103-9.
Sbarbati A, Accorsi D, Benati D, Marchetti L, Orsini G, Rigotti G, Panettiere P. Subcutaneous adipose tissue classification. Eur J Histochem 2010;54:e48.
DOI: https://doi.org/10.4081/ejh.2010.e48
Schenck TL, Koban KC, Schlattau A, Frank K, Sykes JM, Targosinski S, et al. The functional anatomy of the superficial fat compartments of the face: a detailed imaging study. Plast Reconstr Surg 2018;141:1351-9.
DOI: https://doi.org/10.1097/PRS.0000000000004364
Kim YS, Lee KW, Kim JS, Gil YC, Tanvaa T, Shin DH, Kim HJ. Regional thickness of facial skin and superficial fat: application to the minimally invasive procedures. Clin Anat 2019;32:1008-18.
DOI: https://doi.org/10.1002/ca.23331
Cotofana S, Freytag DL, Frank K, Sattler S, Landau M, Pavicic T, et al. The bidirectional movement of the frontalis muscle: introducing the line of convergence and its potential clinical relevance. Plast Reconstr Surg 2020;145:1155-62.
DOI: https://doi.org/10.1097/PRS.0000000000006756
Kondoh S, Matsuo K, Kikuchi N, Yuzuriha S. Pathogenesis and surgical correction of involuntary contraction of the occipitofrontalis muscle that causes forehead wrinkles. Ann Plast Surg 2006;57:142-8.
DOI: https://doi.org/10.1097/01.sap.0000214172.63510.ab
Rohrich RJ, Avashia YJ, Savetsky IL. Prediction of facial aging using the facial fat compartments. Plast Reconstr Surg 2021;147:38S-42S.
DOI: https://doi.org/10.1097/PRS.0000000000007624
Swift A, Liew S, Weinkle S, Garcia JK, Silberberg MB. The facial aging process from the "inside out". Aesthet Surg J 2021;41:1107-19.
DOI: https://doi.org/10.1093/asj/sjaa339
Price KM, Gupta PK, Woodward JA, Stinnett SS, Murchison AP. Eyebrow and eyelid dimensions: an anthropometric analysis of African Americans and Caucasians. Plast Reconstr Surg 2009;124:615-23.
DOI: https://doi.org/10.1097/PRS.0b013e3181addc98
Schelke L, Velthuis PJ, Lowry N, Rohrich RJ, Swift A, Gotkin RH, et al. The mobility of the superficial and deep midfacial fat compartments: an ultrasound-based investigation. J Cosmet Dermatol 2021;20:3849-56.
DOI: https://doi.org/10.1111/jocd.14374
Gosain AK, Klein MH, Sudhakar PV, Prost RW. A volumetric analysis of soft-tissue changes in the aging midface using high-resolution MRI: implications for facial rejuvenation. Plast Reconstr Surg 2005;115:1143-55.
DOI: https://doi.org/10.1097/01.PRS.0000156333.57852.2F
Stuzin JM, Rohrich RJ, Dayan E. The facial fat compartments revisited: clinical relevance to subcutaneous dissection and facial deflation in face lifting. Plast Reconstr Surg 2019;144:1070-8.
DOI: https://doi.org/10.1097/PRS.0000000000006181
Fisher GJ, Varani J, Voorhees JJ. Looking older: fibroblast collapse and therapeutic implications. Arch Dermatol 2008;144:666-72.
DOI: https://doi.org/10.1001/archderm.144.5.666
Sherratt MJ. Tissue elasticity and the ageing elastic fibre. Age (Dordr) 2009;31:305-25.
DOI: https://doi.org/10.1007/s11357-009-9103-6
Goodman GD, Kaufman J, Day D, Weiss R, Kawata AK, Garcia JK, et al. Impact of smoking and alcohol use on facial aging in women: results of a large multinational, multiracial, cross-sectional survey. J Clin Aesthet Dermatol 2019;12:28-39.
Alexis AF, Alam M. Racial and ethnic differences in skin aging: implications for treatment with soft tissue fillers. J Drugs Dermatol 2012;11:s30-2.
Kwon HJ, O J, Cho TH, Choi YJ, Yang HM. The nasolabial fold: a micro-computed tomography study. Plast Reconstr Surg 2020;145:71-9.
DOI: https://doi.org/10.1097/PRS.0000000000006328
Gierloff M, Stöhring C, Buder T, Gassling V, Açil Y, Wiltfang J. Aging changes of the midfacial fat compartments: a computed tomographic study. Plast Reconstr Surg 2012;129:263-73.
DOI: https://doi.org/10.1097/PRS.0b013e3182362b96
Beer GM, Manestar M, Mihic-Probst D. The causes of the nasolabial crease: a histomorphological study. Clin Anat 2013;26:196-203.
DOI: https://doi.org/10.1002/ca.22100
Ezure T, Amano S. Involvement of upper cheek sagging in nasolabial fold formation. Skin Res Technol 2012;18:259-64.
DOI: https://doi.org/10.1111/j.1600-0846.2011.00567.x
How to Cite
Veronese, S., Costa, E., Portuese, A., Ossanna, R., & Sbarbati, A. (2024). Histological analysis of the dermal and hypodermal layers of the face and correlation with high-frequency 24 MHz ultrasonography and elastosonography. European Journal of Histochemistry, 68(2). https://doi.org/10.4081/ejh.2024.3912
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