Evaluation of aging changes of the superficial fat compartments of the midface over time: A computed tomography study.

Background: Previous studies on alterations in superficial fat compartments with age yielded contradictory results; the superficial fat tissue volume or thickness was reported to increase, decrease, or remain unchanged.

Aims: To investigate volumetric and dimensional changes in superficial midfacial fat tissue retrospectively in patients who underwent a repeated computed tomography (CT).

Methods: A total of 262 patients (mean age, 46 years; median elapsed time between two CT imagings, 56 months) were included. Axial and sagittal planes were used for measurements of the medial part of the superficial cheek fat (SCF), which is divided into three compartments. The thickness, width, and height of each compartment were measured, and volumes were calculated for both hemifaces. Additionally, results were compared between males and females, and between three age groups: <45, 45-54, and ≥55 years.

Results: The total volume of SCF and inferior compartment was significantly increased compared with the first CT findings (p < 0.05). Upper and middle compartment volumes were found to decrease with age (p < 0.05). Thickness was decreased in the upper and middle compartments but not in the lower compartment. The width of the lower and middle compartments increased (p < 0.05), while the upper compartment did not show a significant change with age (p > 0.05). The height of the superficial fat layer was significantly increased at follow-up (p < 0.05). The results were similar for both sexes and all age groups (p > 0.05).

Conclusions: SCF undergoes significant volume and dimensional changes with aging. Therefore, superficial fat tissue should be considered for enhancement of cosmetic treatments.