Three-dimensional structure of the orbicularis retaining ligament: an anatomical study using micro-computed...

Area of Science:

• Anatomy
• Imaging Science
• Dermatology

Background:

• The orbicularis retaining ligament (ORL) is vital for facial structure and contour.
• It is susceptible to damage during dissection, necessitating advanced imaging techniques.
• Understanding the ORL's detailed anatomy is key to explaining facial aging and deformities.

Purpose of the Study:

• To non-destructively investigate the three-dimensional structure of the orbicularis retaining ligament (ORL).
• To characterize the microarchitecture and composition of the ORL using micro-computed tomography (mCT).
• To correlate ORL structure with age-related cutaneous deformities.

Main Methods:

• Utilized micro-computed tomography (mCT) with phosphotungstic acid (PTA) preparation on 22 human cadaver specimens.
• Acquired multidirectional images for 3D reconstruction of the ORL.
• Performed modified Verhoeff Van Gieson staining and immunofluorescence for tissue analysis.

Main Results:

• The ORL presents as a multilayered, plexiform meshwork of continuous tiny fibroelastic plates.
• Preorbicularis fibers are more layered and intricate than retro-orbicularis fibers.
• ORL fiber complexity, density, and dermal anchorage increase laterally and towards the dermis.

Conclusions:

• The orbicularis retaining ligament (ORL) is a complex fibroelastic meshwork, not a simple band.
• Its intricate structure and dermal connections are critical for facial support.
• Cutaneous deformities may result from a combination of subcutaneous changes and ORL alterations.