Anatomy of the fibro-septal network and ligamentous apparatus of the face: comparative analysis of static and dynamic regions during aging

Objective: To conduct a morphofunctional analysis of the fibro-septal network and ligamentous apparatus in static (temporal, parotidmasseteric) and dynamic (zygomatic, buccal) facial regions with assessment of age-related changes and fixation capabilities. Materials and methods. Dissection of two cadaveric heads with preliminary silicone filling of vessels was performed. Layer-by-layer dissection was conducted with isolation of skin, subcutaneous fat, musculoaponeurotic layer (SMAS), and main retaining ligaments. Methods of loose fibrous tissue endoscopy, biomechanical testing, and photodocumentation were applied. Results. Regional differences in fibro-septal network structure were revealed. The temporal region is characterized by dense connective tissue with pronounced fibro-septal network and temporal adhesion as the main fixation structure. The zygomatic region contains mobile fat compartments and zygomatic ligament, which determines susceptibility to gravitational ptosis. The buccal region is distinguished by high dynamic activity with elastic septa and buccal ligament. The parotid-masseteric region is represented by dense, minimally mobile structures with masseteric ligament. Biomechanical changes during aging: 15–20% decrease in elastic modulus in temporal region, 30–35% reduction in collagen density in zygomatic region, 25–30% increase in ligament extensibility in buccal region. Conclusion. The fibro-septal network and ligamentous apparatus demonstrate regional specificity of structure and function. The greatest age-related changes are observed in dynamic zones. The obtained data substantiate the necessity of a personalized approach to correction of age-related changes considering biomechanical characteristics and local morphological features.