Facial Anatomy for Filler Injection: The Superficial Musculoaponeurotic System (SMAS) Is Not Just for Facelifting

Clin Plast Surg. 2019 Oct;46(4):603-612. doi: 10.1016/j.cps.2019.06.007.

Abstract

Facial volumization with filler and/or fat has become an integral part of global facial rejuvenation and provides a finishing touch to harmonize the face after surgical repositioning of soft tissue. However, facial injection is not devoid of complications that can lead to suboptimal outcomes. This article journeys through the facial anatomy for the injector emphasizing the superficial musculoaponeurotic system as a centralized depth gauge facilitating navigation into deep and superficial injection targets. Based on this principle, the fat compartments, ligaments, potential spaces, and neurovascular structures are categorized into planes to assist the injector in performing safe and accurate volume correction.

Keywords: Angular artery; Deep lateral chin fat compartment; Facial artery; Facial fat compartments; Osseocutaneous ligaments; Pre-zygomatic space; Superficial temporal artery; Superificial musculoaponeurotic system (SMAS).

Publication types

  • Review

MeSH terms

  • Cadaver
  • Face / anatomy & histology
  • Face / surgery*
  • Humans
  • Rejuvenation*
  • Rhytidoplasty / methods*
  • Superficial Musculoaponeurotic System / anatomy & histology*
  • Superficial Musculoaponeurotic System / surgery