title: Facial Contouring by Targeted Restoration of Facial Fat Compartment Volume: The Midface.
abstract: BACKGROUND
  Recent anatomical findings have suggested that facial fat distribution is complex and changes with age. Here, the authors developed a grafting technique based on the physiologic distribution and volume changes of facial fat compartments to achieve a youthful and natural-appearing face.
  
  
  METHODS
  Forty cadaveric hemifaces were used for the dissection of fat compartments and neurovascular structures in the midface area. Seventy-eight patients were treated for cheek atrophy using the authors' targeted restoration of midface fat compartment volume. The outcome was evaluated by a two-dimensional assessment, malar lipoatrophy assessment, and a satisfaction survey.
  
  
  RESULTS
  The medial and lateral parts of the deep medial cheek fat compartment were separated by a septum arising from the lateral border of the levator anguli oris muscle. The angular vein traveled between the deep medial cheek fat compartment and the buccal fat pad, 12 mm from the maxilla. A total volume of 29.3 ml of fat was grafted per cheek for each patient. A 12-month follow-up revealed an average volume augmentation rate of 27.1 percent. Pleasing and elevated anterior projection of the cheek and ameliorated nasolabial groove were still obvious by 12 months after the procedure. In total, 95.2 percent of the patients were satisfied with their results.
  
  
  CONCLUSIONS
  The present study provides the anatomical and clinical basis for the concept of compartmentally based fat grafting. It allows for the restoration of facial fat volume close to the physiologic state. With this procedure, a natural and youthful facial contour could be rebuilt with a high satisfaction rate.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Wenjin
authors.initials: W
authors.lastname: Wang
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Ru-Lin
authors.initials: RL
authors.lastname: Huang
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Jia
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Herrler
authors.initials: H
authors.lastname: Tanja
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Peijuan
authors.initials: P
authors.lastname: Zhao
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Chen
authors.initials: C
authors.lastname: Cheng
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Sizheng
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Lee L Q
authors.initials: LLQ
authors.lastname: Pu
authors.affiliation: Shanghai, People's Republic of China; Sacramento, Calif; and Munich, Germany.|From the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; the Division of Plastic Surgery, University of California, Davis; and the Department of General, Trauma, Hand, and Plastic Surgery, Ludwig-Maximillians-Universität München.
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Li
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation*; D000293:Adolescent; D000328:Adult; D002102:Cadaver; D002610:Cheek; D003357:Cosmetic Techniques; D005145:Face / Q000033:anatomy & histology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D055815:Young Adult