title: Superficial Fascia (SF) in the Cheek and Parotid Area: Histology and Magnetic Resonance Image (MRI).
abstract: BACKGROUND
  The aim of this study is to compare the superficial fascia (SF) in the cheek and parotid areas histologically and through MRI.
  
  
  METHODS
  An in vitro study included a histological report and an MRI of the cheek of two Korean adult cadavers. The in vivo study included 100 MRI images and three axial image cuts (mandibular condyle, notch, and half the distance between the top of the condyle and the angle). Four angles, one length, and four thicknesses were measured and compared.
  
  
  RESULTS
  The MRI results were in concord with the gross specimen or histology. The SF consisted of multilayered horizontal and vertical fibrous connective tissues at all three levels in both the histology and MRI. In the cheek, both histology and MRI showed horizontal fibrous connective tissues which were connected with the zygomaticus major, visualized as a continuous membrane (membranous layer, MSF). MSF divided the SF into the superficial fatty layer (SFS) and the deep fatty layer. The thickness of the SF depended upon the thickness of the SFS since the thickness of the MSF was very similar irrespective of the three levels. The thickness of the SFS was thicker in females than in males. At the condyle level, the AS-PS angle (AP line-the most posterior superficial fascia angle) and AS-PS length increased significantly (p = 0.001, y = 0.15x + 16.19, and p < 0.001, y = 0.33x + 14.68, respectively).
  
  
  CONCLUSIONS
  We hope the information we have gathered could be useful to provide subcutaneous dissection or sub-SMAS dissection in facelift surgeries.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic Surgery, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon, 22332, Korea. jokerhg@inha.ac.kr.
authors.forename: Kun
authors.identifier: http://orcid.org/0000-0002-1994-2538
authors.initials: K
authors.lastname: Hwang
authors.affiliation: Department of Plastic Surgery, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon, 22332, Korea.
authors.forename: Hun
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Anatomy, Inha University School of Medicine, Incheon, Korea.
authors.forename: Dae Joong
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon, 22332, Korea. kimyeoju@hanmail.net.
authors.forename: Yeo Ju
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon, 22332, Korea.
authors.forename: Young Hye
authors.initials: YH
authors.lastname: Kang
mesh_terms: D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002102:Cadaver; D002610:Cheek / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D004210:Dissection; D005205:Fascia / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D056910:Republic of Korea; D015361:Rhytidoplasty / Q000379:methods
keywords: Cheek; Histology; Magnetic resonance imaging; Subcutaneous tissue