FACIAL ANATOMY

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The face is composed of multiple tissue layers starting with the skin superficially extending deeply to the facial skeleton. An interplay of genetic and environmental factors causes changes in skin elasticity, texture, and strength, leading to the formation of superficial rhytids.Deep to skin is a subcutaneous layer that is connected to the superficial muscular aponeurotic system. Recent anatomical studies have identified distinct fat pads in this layer, separated by septal boundaries that also function as retaining ligaments.Specialized retaining ligaments at key anatomic sites serve to anchor the overlying soft-tissue and skin to the bony skeleton.Another layer of distinct fat pads lies deep to the superficial muscular aponeurotic system, adding volume to further define structural contours of the face.The facial artery and vein reside in different planes of the face, starting deep inferiorly as they cross the mandible, and becoming superficial as they course superiorly to become the angular vessels. A thorough knowledge of facial anatomy, and in particular, the facial fat pads and vasculature, is essential to optimize aesthetic and safety outcomes when injecting fillers, respectively.