Three-dimensional adipofascial and dermal structures involved in forehead crease formation

Forehead creases are a visible sign of aging, and various interventions aim to reduce them. While clinical approaches like fillers and surgery exist, the anatomical basis for these creases remains unclear. Prior research has shown that skin folds involve complex interactions between layers of tissue. However, no prior work had resolved the exact subcutaneous structures responsible for forehead crease formation. This gap motivated the need for a detailed anatomical investigation. Existing knowledge lacked consensus on how fibrous structures and collagen influence crease persistence. This paper's contribution lies in identifying the fibrous fatty septal structures linking the dermis to the frontalis muscle. By examining these structures, the study addresses a key anatomical uncertainty. The findings may help refine treatment selection criteria for forehead rejuvenation. This work provides a clearer anatomical framework for future clinical strategies.

The aim of this study was to investigate the subcutaneous structures involved in forehead crease formation. Researchers sought to clarify how fibrous fatty septa contribute to the persistence of skin folds. Understanding these structures could improve treatment selection for forehead rejuvenation. The study focused on the anatomical relationship between the dermis and the frontalis muscle. By examining tissue samples, the researchers aimed to identify structural differences in creased versus normal skin areas. This approach allows for a more precise understanding of the anatomical basis of aging creases. The motivation stems from the lack of consensus on appropriate treatment strategies. The study's findings may support the development of targeted interventions for forehead creases.

The researchers obtained forehead sections from five unfixed Asian cadavers. Tissues containing forehead creases were removed from the periosteum for analysis. Gross observation was used to examine the overall structure of the skin and underlying tissues. Radiography provided additional insights into tissue density and spatial arrangement. Histological techniques allowed for microscopic examination of tissue layers. Nano-computed tomography was employed to visualize fine structural details. The study focused on the fibrous fatty septae connecting the dermis to the frontalis muscle. Multiple imaging and observational methods were combined to confirm structural patterns.

The study revealed a three-dimensional fibrous structure linking the dermis to the frontalis muscle. This structure was dense in areas corresponding to visible skin folds. Collagen fibers extended from the dermis toward the epidermis in these regions. The fibrous fatty septae were sparse and thin in non-creased areas. Skin appendages were fewer or absent near creases compared to normal skin. The epidermis was thicker in creased regions than in surrounding tissue. Dermal papillae were more developed in areas of skin folds. These findings suggest that structural density and collagen orientation influence crease formation.

The study concludes that fibrous fatty septae between the dermis and frontalis muscle contribute to forehead crease formation. The density of these structures correlates with the visibility of skin folds. Collagen fibers extending toward the epidermis may reinforce crease persistence. Structural differences in epidermal thickness and dermal papillae were observed. These anatomical features may explain the plastic nature of forehead creases. The findings suggest that treatment strategies should consider these structural characteristics. The authors propose that understanding fibrous fatty septae could improve treatment selection. These conclusions align with the observed anatomical patterns in the study samples.