Anatomical Basis for Malar Augmentation Injection With the Zygomatic Ligamentous System

Area of Science:

• Anatomy
• Cosmetic Surgery
• Facial Aesthetics

Background:

• Malar augmentation injections are increasingly popular for facial rejuvenation.
• The precise anatomical locations for optimal malar injection sites remain undefined.
• Identifying these sites is crucial for effective and safe cosmetic procedures.

Purpose of the Study:

• To determine ideal anatomical injection sites for malar augmentation.
• To consider the distribution of facial ligaments, muscles, and vessels for safety and efficacy.
• To provide precise anatomical landmarks for practitioners.

Main Methods:

• Dissection of 18 cadaver heads to analyze the zygomatic ligamentous system and muscle positions.
• CT scanning and 3D vessel reconstruction of 66 cadaver heads.
• Radiological evaluation and experimental injections followed by dissection for safety confirmation.
• Prospective clinical study with 5 patients, utilizing 2D and 3D photography for pre- and post-injection comparison.

Main Results:

• Three distinct injection sites were identified and defined anatomically.
• Site 1: Along the zygomatic arch (excluding the anterior quarter and midline).
• Site 2: On the zygomatic body, superior to the infraorbital foramen and medial to the jugale.
• Site 3: In the anteromedial midface, approximately 30 mm below the lateral canthus.

Conclusions:

• The identified three injection sites offer effective malar augmentation.
• These sites are located within the range of facial ligaments, enhancing lifting effects.
• Injection at these specific sites helps minimize potential complications during malar augmentation procedures.