title: [Contribution to the anatomical and surgical study of the infra orbital area. Clinical applications to the tear trough area].
abstract: OBJECTIVE
  To define the anatomy of the infra orbital area and assess the possible connections with the facial morphotypes identifying the tears trough. To deduce therapeutic proposition concerning the management of this area in aesthetic medicine or surgery.
  
  
  METHODS
  Anatomic dissections of 10 fresh specimens not frozen and not formalin. Dissection layer by layer from skin to bones paying special attention to the infra orbital superficial muscles and the distribution of subcutaneous fat.
  
  
  RESULTS
  In this study, it was precised the existence of zygomaticus superficialis and levator genae muscles whose variations in the connections with the orbicularis oculi muscle is probably the origin of the diversity of human facial expression. On the other hand, the tear trough seems to depend on different distributions of the anatomical complex formed by these muscles with the subcutaneous fat and skin that covers it. An anatomical classification into three muscle types has been proposed.
  
  
  CONCLUSIONS
  The main variations between individual facial expression are related to a different muscular anatomy from one subject to another. The myological classical anatomic description, too stereotyped, can not explain those differences. The classification proposed by the authors can differentiate the facial morphotypes in the infra orbital area and offer therapeutic solutions.
authors.affiliation: Institut Azurdéen d'ORL et de Chirurgie de la Face, 25 Avenue Jean Médecin, F-06000 Nice, France. yves.saban@wanadoo.fr
authors.forename: Y
authors.initials: Y
authors.lastname: Saban
authors.forename: R
authors.initials: R
authors.lastname: Polselli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002610:Cheek / Q000033:anatomy & histology* / Q000601:surgery*; D005143:Eyelids / Q000033:anatomy & histology* / Q000601:surgery*; D005152:Facial Muscles / Q000033:anatomy & histology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male