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Area of Science:

  • Plastic Surgery
  • Anatomy
  • Facial Aesthetics

Background:

  • The vector of the superficial musculoaponeurotic system (SMAS) in rhytidectomy is often related to the zygomaticus major muscle (ZMM) to prevent distortion.
  • Current literature lacks data on the true orientation of the ZMM in the midface.

Purpose of the Study:

  • To define the vector of the ZMM in relation to the Frankfort horizontal plane.
  • To provide anatomical data for improved rhytidectomy techniques.

Main Methods:

  • Measurement of the ZMM orientation as an angle relative to the Frankfort horizontal plane.
  • Data collected from 100 patients undergoing deep plane rhytidectomy (200 hemifaces).

Main Results:

  • The average ZMM angle was 59° (SD 6°, range 41-72°) relative to the Frankfort horizontal plane.
  • A statistically significant age-related pattern was observed: more acute angles below 60 years and more obtuse angles above 60 years.

Conclusions:

  • The native ZMM vector shows significant variability among patients.
  • Standard SMAS redraping vectors may need reconsideration; customized vectors are advised.
  • Aging impacts ZMM orientation due to soft tissue and bony changes, increasing individual variability.