Surgical anatomy of the midcheek: facial layers, spaces, and the midcheek segments

Abstract

This article describes the surgical anatomy of the midcheek. The article's key points: (1) Structurally, the midcheek is formed by the convergence of three components: the lid-cheek segment, the malar segment, and the nasolabial segment. (2) The midcheek skeleton provides the attachment for the muscles and ligaments of both the lower lid and the upper lip. (3) The midcheek contains proportionally more spaces and fewer ligaments than other parts of the face. (4) Each midcheek segment overlies a specific facial space. (5) The lid-cheek contour transition does not have a fixed relationship to the inferior orbital rim. (6) The youthful lid-cheek transition is above the orbital rim and the aged is below the rim. (7) Facial nerve branches course in predictable locations.