Overview
The existence of a discrete malar fat pad was not widely recognized. Building on Hamra's description of thicker fat over the front of the midface in the deep-plane rhytidectomy, the author used cadaver and clinical studies to define this fat pad. He then describes how to dissect and lift it to soften a prominent nasolabial fold.
Findings
- Cadaver and clinical studies confirm a consistent, localized malar fat pad under the skin over the zygoma and maxilla.
- Downward movement of the skin below the eye and the malar fat pad makes the nasolabial fold more prominent.
- Dissection starts at the malar eminence in the plane of the orbicularis oculi, above the origins of the zygomaticus and levator muscles, which are covered by the SMAS.
- An easily dissected plane lies beneath the fat pad and extends to the nasolabial crease.
- The fat pad is undermined and advanced outward by pulling on the skin flap.
- It is fixed upward with sutures between its outer edge and the fascia under the skin at the side of the cheekbone.
- The abstract gives no patient numbers or outcome rates.
What it means for a patient
- A deep fold from the nose to the mouth corner partly comes from the cheek fat pad and skin sliding down.
- Some facelift techniques lift this cheek fat pad back up and stitch it in place to soften the fold.
- Ask your surgeon whether your facelift addresses the cheek fat and the nasolabial fold, and how.
- The abstract describes anatomy and technique but gives no results or complication rates.
Why this paper matters
It defined the malar fat pad as a distinct structure and linked its descent to the nasolabial fold. It described a dissection plane and suture fixation for lifting the pad during facelift. Cited 164 times (NIH iCite, 2026-09-25).
Terms
- Malar fat pad: a pad of fat under the skin over the cheekbone.
- Nasolabial fold: the crease from the side of the nose to the corner of the mouth.
- Malar eminence: the most prominent point of the cheekbone.
- Zygoma: the cheekbone.
- Maxilla: the upper jawbone.
- SMAS: the layer of muscle and fibrous tissue under the facial skin and fat.
- Undermining: separating tissue from the layer beneath it.