The anatomical approach of temporal fat compartments and its significance in temporal large-volume fat transplantation
10.3760/cma.j.cn114453-20220727-00235
- VernacularTitle:颞部脂肪室的解剖学研究及在颞部大容量脂肪移植中的意义
- Author:
Haojie GE
1
;
Biaobin LIN
;
Bairong FANG
Author Information
1. 中南大学湘雅二医院整形美容（烧伤）外科，长沙 410011
- Keywords:
Anatomy;
Fat compartment;
Fat grafting;
Temporal rejuvenation
- From:
Chinese Journal of Plastic Surgery
2023;39(6):646-654
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the anatomical levels and injection approaches of the major temporal fat compartments through cadaveric head dissection and to analyze the efficacy of high-volume fat transplantation of the temporal region in a clinical retrospective research.Methods:To clarify the safe and stable levels of high-volume filling of the temporal fat compartment by dissecting the temporal fat compartment of 5 fresh cadaveric heads (10 sides, 25-50 years old, 2 males, 3 females). We retrospectively analyzed the data of patients with temporal fat transplantation admitted to the Second Xiangya Hospital of Central South University and Changsha Mylike Medical Cosmetic Hospital from January 2020 to January 2021. According to the levels and volume of fat filling injection, the patients were divided into large-volume group and conventional group. In the large-volume group the patients were filled with at least three fat compartments with a filling volume of more than 15 ml, while in the conventional group only with 1 to 2 layers, which were the subcutaneous fat and the middle temporal fascia, and the filling volume was generally less than 15 ml. Fat injections were performed with a needle entry within the frontal hairline, targeting the main fat compartments. We compared and studied the mean injection volume per side, postoperative surgeon’s Likert scale score, patient satisfaction and other indicators in the two groups of cases. Stromal vascular fraction-gel(SVF-gel), which was made from surplus fat during the initial operation, was used to locally fine-tune the effect at the 3-month follow-up evaluation.Results:The anatomical study revealed the existence of three main fat compartments in the temporal region: subcutaneous fat layer, superficial and deep temporal fat pad. In the elderly cadavers, the subcutaneous fat was thin, the superficial temporal fat pad and deep temporal fat pad atrophied obviously, and the supporting effect on temporal superficial soft tissue was significantly weakened. The deep temporal fat pad showed obvious atrophy with a certain degree of downward movement. A total of 50 women who underwent bilateral temporal fat transplantation were enrolled in the clinical study, with 25 in the conventional group and 25 in the large-volume group. The age of the patients in the conventional group was (32.7±7.1) years, and the body mass index (BMI) was (20.2±1.9) kg/m 2. In the large-volume group, the age was (32.5±8.3) years, and the BMI was (19.8±2.0) kg/m 2. There were no significant differences in age and BMI between the two groups (all P>0.05). The filling volume was (19.66±4.61) ml/side in the large-volume group, with a Likert scale score of (4.32±0.63) and the patient satisfaction was 92.0%(23/25); the filling volume was (11.06±2.62) ml/side in the conventional group, with a Likert scale score of (3.32±0.80) and the patient satisfaction was 68.0%(17/25). There were statistical differences between the two groups (all P<0.05), suggesting that the large-volume group had better efficacy and patients were more satisfied. No severe complications such as infection, liquefaction, embolism, and nerve injury occurred in all patients during the follow-up period. Conclusion:Anatomical studies have proved that the main three-layer fat compartments filling in the temporal region have a clear approach, especially the feasibility of the puncture approach of the deep temporal fat pad, which provides the basis and feasibility for temporal fat filling with large volume. Compared with the conventional fat filling, multi-level and large-volume filling can significantly improve the surgical effect and patient satisfaction.
