Variability of the midfacial muscles

Analysis of 50 hemifacial cadaver dissections

Joel E. Pessa, Vikram P. Zadoo, Earle K. Adrian, Cheng H. Yuan, Jason Aydelotte, Jaime R. Garza

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

The region of the midface represents a challenging area to both reconstructive and aesthetic surgeons. An anatomic study was performed that attempted to identify patterns and variations of the muscular anatomy. The goals of this study were twofold: to identify patterns and variability of the midfacial muscles that might impact on reconstructive efforts and to attempt to correlate this anatomy with features of the overlying soft tissues, specifically the nasolabial crease. Fifty hemifacial cadaver dissections were performed. The information collected was assembled into a large data base, and statistical significance was analyzed using Fisher's exact probability test. Results demonstrated that, although a great degree of variability exists with respect to the midfacial muscles, seven distinct patterns of these muscles did emerge. The most common pattern was the presence of a levator alae nasi, levator labii superioris, and zygomaticus major, which occurred in 44 percent of specimens. Specimens that possessed a risorius, zygomaticus minor, or both, were relatively uncommon. The consistent presence of the levators suggests adding a superior vector to recreate a smile in facial reanimation surgery. Two important anatomic variations were noted. A bifid zygomaticus major was found to be present in 34 percent of individuals. Because the inferior bundle had a dermocutaneous insertion, this anomaly may represent the anatomic correlate of a cheek 'dimple.' A second anomaly noted was the lateral cheek crease, which appeared to be associated with a cutaneous attachment from the underlying platysma muscle. However, no correlation could be found for facial muscle pattern and the overlying nasolabial crease structure. This lack of correlation may indicate that the facial muscles alone do not dictate the structure of the nasolabial crease and that other dynamic factors are involved in determining this feature of the aging face.

Original languageEnglish (US)
Pages (from-to)1888-1893
Number of pages6
JournalPlastic and Reconstructive Surgery
Volume102
Issue number6
StatePublished - Nov 1998

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Cadaver
Facial Muscles
Dissection
Cheek
Muscles
Anatomy
Anatomic Variation
Esthetics
Databases
Skin

ASJC Scopus subject areas

  • Surgery

Cite this

Pessa, J. E., Zadoo, V. P., Adrian, E. K., Yuan, C. H., Aydelotte, J., & Garza, J. R. (1998). Variability of the midfacial muscles: Analysis of 50 hemifacial cadaver dissections. Plastic and Reconstructive Surgery, 102(6), 1888-1893.

Variability of the midfacial muscles : Analysis of 50 hemifacial cadaver dissections. / Pessa, Joel E.; Zadoo, Vikram P.; Adrian, Earle K.; Yuan, Cheng H.; Aydelotte, Jason; Garza, Jaime R.

In: Plastic and Reconstructive Surgery, Vol. 102, No. 6, 11.1998, p. 1888-1893.

Research output: Contribution to journalArticle

Pessa, JE, Zadoo, VP, Adrian, EK, Yuan, CH, Aydelotte, J & Garza, JR 1998, 'Variability of the midfacial muscles: Analysis of 50 hemifacial cadaver dissections', Plastic and Reconstructive Surgery, vol. 102, no. 6, pp. 1888-1893.
Pessa JE, Zadoo VP, Adrian EK, Yuan CH, Aydelotte J, Garza JR. Variability of the midfacial muscles: Analysis of 50 hemifacial cadaver dissections. Plastic and Reconstructive Surgery. 1998 Nov;102(6):1888-1893.
Pessa, Joel E. ; Zadoo, Vikram P. ; Adrian, Earle K. ; Yuan, Cheng H. ; Aydelotte, Jason ; Garza, Jaime R. / Variability of the midfacial muscles : Analysis of 50 hemifacial cadaver dissections. In: Plastic and Reconstructive Surgery. 1998 ; Vol. 102, No. 6. pp. 1888-1893.
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