The Submental Fat Compartment of the Neck

Division of Plastic Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.
Seminars in Plastic Surgery 11/2009; 23(4):288-91. DOI: 10.1055/s-0029-1242180
Source: PubMed


The anatomic understanding of the superficial compartments of the head and neck are evolving. Recently, studies have shown that the superficial fat is sequestered into separate "compartments"; however, the superficial anatomy of the submental region of the neck has yet to be defined, and improved understanding of this area may lead to advances in our ability to rejuvenate the neck. This cadaveric investigation revealed that there is one superficial fat compartment in the submental region. The anterior boundary of this compartment, previously without name, has been labeled the "submental septum." The posterior boundary of the submental fat compartment is created by a septum that arises from the platysma at a point superficial to the hyoid. Because this area is over the hyoid, it has been named the "suprahyoid septum." The lateral septal boundaries have been labeled the "digastric septae."

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    • "Patients with unwanted submental fat (SMF) are frequently dissatisfied with the appearance of their face and chin [1]. This preplatysmal subcutaneous fat that accumulates in the submental compartment leads to loss of mandibular line definition and a perception of an aging or overweight appearance [2, 3]. "
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    ABSTRACT: Background The injectable adipocytolytic drug ATX-101 is the first nonsurgical treatment for the reduction of submental fat (SMF) to undergo comprehensive clinical evaluation. This study aimed to confirm the efficacy and safety of ATX-101 for SMF reduction through a post hoc pooled analysis of two large phase 3 studies. Methods Patients with unwanted SMF were randomized to receive 1 or 2 mg/cm2 of ATX-101 or a placebo injected into their SMF during a maximum of four treatment sessions spaced approximately 28 days apart, with a 12-week follow-up period. The proportions of patients with reductions in SMF of one point or more on the Clinician-Reported SMF Rating Scale (CR-SMFRS) and the proportions of patients satisfied with the appearance of their face and chin [Subject Self-Rating Scale (SSRS) score ≥4] were reported overall and in subgroups. Other efficacy measures included improvements in the Patient-Reported SMF Rating Scale (PR-SMFRS), calliper measurements of SMF thickness, and assessment of skin laxity [Skin Laxity Rating Scale (SLRS)]. Adverse events and laboratory test results were recorded. Results Significantly greater proportions of the patients had improvements in clinician-reported measures (≥1-point improvement in CR-SMFRS: 58.8 and 63.8 % of the patients who received ATX-101 1 and 2 mg/cm2, respectively, and 28.6 % of the placebo recipients; p
    Aesthetic Plastic Surgery 07/2014; 38(5). DOI:10.1007/s00266-014-0364-9 · 0.96 Impact Factor
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    • "These septal boundaries, which act as a retaining system, were henceforth used as the anatomic basis of the fat compartments.16,24 This methodology has since been replicated by additional groups25,26 to identify additional facial fat compartments in cadaveric dissections. "
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    ABSTRACT: The recent identification of the facial fat compartments has greatly affected our understanding of midfacial aging. This article chronicles the discovery of these fat compartments including the shift of attention from a purely gravitational to a volumetric approach to facial aging and the series of methodologies attempted to ultimately define the anatomy of these compartments. The revived interest in volumetric facial rejuvenation including compartment-guided augmentation techniques is discussed. Lastly, the article discusses interesting distributional patterns noted in these fat compartments likely related to the different mechanical and biologic environments of the deep and superficial facial fat pads.
    12/2013; 1(9):e92. DOI:10.1097/GOX.0000000000000035
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    ABSTRACT: Even before physicians began to inject botulinum toxin A (BTXA) for the treatment of facial dynamic lines, we were already aware of the possibility of treating the platysma band and the transversal lines of the neck. There were few doctors claiming good results, but there were still questions about why, when, how, and in whom how to inject BTXA, as well as questions about the clinical results and complications of course. Now that we have being treating the lines of the neck through the platysmal bands for some time, with great emphasis at the contouring of the jaw line for the global facial rejuvenation, we can discuss treatment of the platysma muscle and analyze its dynamics, identification, and limits, and also have a better idea of how to manage the injection of BTXA in this area with good results. This article analyzes the pattern of a series of platysma muscle treatment to determine if there is a model that could be followed for the contouring of the face and neck by comparing the current knowledge about the behavior, position, and results of the BTXA injection sites based on the initial idea of treating the platysmal bands and the transversal cervical lines of the neck. We randomly selected 40 patients from our private clinic treated between 2006 and 2011 who had have botulinum toxin injections for the recontouring of the face to analyze if there was a pattern of injection to follow as a model for the treatment of the platysma. They were all female, as there were no males that had had any treatment for this indication in our files. These patients had received at least two treatments, resulting in a total of 90 treatments for the neck during 15 months, with the total dose injected per session varying from 10 to 70 units. We have made a retrospective evaluation of the pre- and post-treatment pictures, checking the effective clinical results after the treatment and making sure that the patient was included in the discussion. There was not any exact model of points, distribution, quantity, and constant pattern for the treatment of the platysma muscle for the contouring of the face. There were differences between the patients and in the same patient (e.g., different pattern from the right side and the left side). The clear knowledge of the muscular distribution through its dynamic action to work as a mimetic muscle that might change the facial lower contour is the key aspect for this treatment.
    06/2012; 1(2). DOI:10.1007/s13671-012-0013-y
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