title: Biomechanical properties of the facial retaining ligaments.
abstract: OBJECTIVE
  Osteocutaneous facial retaining ligaments play an important role in the aging face. We sought to better characterize the biophysical properties of these ligaments and, in doing so, provide an empirical basis for the natural descent seen in facial aging.
  
  
  METHODS
  Five fresh frozen cadaver heads yielding 10 hemifaces were dissected to expose the orbital, zygomatic, buccomaxillary, and mandibular osteocutaneous ligaments. Each ligament was assessed and subjected to biomechanical testing. The main outcome measures included ligament dimensions, stiffness, percentage of elongation, and force to initial and ultimate failure.
  
  
  RESULTS
  Initial and ultimate failure testing revealed the zygomatic ligament to be strongest, followed by the orbital, mandibular, and maxillary ligaments. The zygomatic ligament was also stiffest, followed by the orbital, maxillary, and mandibular ligaments. The percentage of elongation acted as a surrogate marker of elasticity, with the greatest elasticity maintained by the mandibular ligament, followed by the orbital, zygomatic, and buccomaxillary ligaments. Ligament dimensions and biophysical properties did not vary relative to cadaveric hemiface, age, or sex.
  
  
  CONCLUSIONS
  To our knowledge, this is the first investigation to quantify the biomechanical properties of the facial retaining ligaments. Inherent ligament properties seem to be related to the changes observed in facial aging, although further study is required.
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Brandt
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Hassa
authors.forename: Kathryn
authors.initials: K
authors.lastname: Roth
authors.forename: Bret
authors.initials: B
authors.lastname: Wehrli
authors.forename: Corey C
authors.initials: CC
authors.lastname: Moore
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D004210:Dissection; D005145:Face / Q000033:anatomy & histology / Q000502:physiology*; D005147:Facial Bones / Q000033:anatomy & histology / Q000502:physiology; D005152:Facial Muscles / Q000033:anatomy & histology / Q000502:physiology; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000033:anatomy & histology / Q000502:physiology*; D008297:Male; D012680:Sensitivity and Specificity; D013718:Tensile Strength