{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:34:50Z","timestamp":1790044490889,"version":"4.0.1"},"reference-count":12,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["JAMA Facial Plast Surg"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>During anatomic and surgical dissections, a connection was seen between the superficial layer of the deep temporal fascia and the prezygomatic area. These findings were in contrast to previous evaluations. This study defines this connection, which is important to understand from both surgical and anatomic standpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To define the connection between the superficial layer of the deep temporal fascia and the prezygomatic area and demonstrate the presence of a deep fascial layer in the midface.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and Setting<\/jats:title>\n                    <jats:p>Anatomical study performed at the Laboratoire d\u2019Anatomie de la Facult\u00e9 de M\u00e9decine de Nice, Sophia Antipolis, France; at the Centre du Don des Corps de l\u2019Universit\u00e9 Paris Descartes, Paris, France; and at the Department of Experimental Medicine, Histology, and Embryology Unit of the University of Pavia, Pavia, Italy. Twenty-four hemifaces of 14 white cadavers were dissected to define the relationship between deep temporal fascia and the midface. Four biopsy samples were harvested for histologic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Dissection of 24 hemifaces from the fresh cadavers revealed the following findings. There is a connection of the deep fascia of the temple (superficial layer of deep temporal fascia) to the midface that divides the fat deep to the orbicularis muscle into 2 layers. One layer of fat is the so-called suborbicularis oculi fat (SOOF), which is superficial to the deep fascia, and the other layer of fat (preperiosteal) is deep to the deep fascia and adherent to malar bone. These findings are in contrast to previous anatomical findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 12 hemifaces, the superficial layer of the deep temporal fascia directly reached the prezygomatic area as a continuous fascial layer. In 16 hemifaces, the superficial sheet of the deep temporal fascia inserted at the level of the zygomatic and lateral orbital rim and continued as a deep fascial layer over the prezygomatic area. In all specimens, a deep fascial layer was present in the prezygomatic-infraorbital area. This deep fascial layer is adherent to the muscles of the infraorbital area, and it divided the fat located deep to the orbicularis oculi muscle into 2 layers: the SOOF and a deeper layer. Histologic examination of the biopsy samples confirmed these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This study demonstrates the existence of a deep fascial layer in the midface. This fascia is connected to the superficial layer of the deep temporal fascia, and it divides the fat deep to the orbicularis oculi muscle into 2 layers. This new finding carries interesting implications related to the classic concept of the superficial musculoaponeurotic system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/archfaci.jamanetwork.com\/public\/instructionsForAuthors.aspx#SecLevelofEvidence\">NA<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamafacial.2013.53","type":"journal-article","created":{"date-parts":[[2013,6,27]],"date-time":"2013-06-27T18:31:39Z","timestamp":1372357899000},"page":"36-41","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["The Suborbicularis Oculi Fat (SOOF) and the Fascial Planes"],"prefix":"10.1177","volume":"16","author":[{"given":"Chiara","family":"Andretto Amodeo","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, University of Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Casasco","sequence":"additional","affiliation":[{"name":"Histology and Embryology Unit, Department of Experimental Medicine, University of Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Icaro Cornaglia","sequence":"additional","affiliation":[{"name":"Histology and Embryology Unit, Department of Experimental Medicine, University of Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Kang","sequence":"additional","affiliation":[{"name":"Department Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles"},{"name":"now with the Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery, City of Hope National Medical Center, Duarte, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory S.","family":"Keller","sequence":"additional","affiliation":[{"name":"Department Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2014,1,16]]},"reference":[{"key":"e_1_3_1_2_2","unstructured":"Gray H. Anatomy of the Human Body. 20th ed (thoroughly revised and reedited by Lewis WH. New York NY: Bartleby.com; 2000). Philadelphia PA: Lea and Febiger; 1918:\u00a7IV.4.e: the muscles of mastication."},{"issue":"1","key":"e_1_3_1_3_2","first-page":"17","article-title":"Surgical anatomy and blood supply of the fascial layers of the temporal region.","volume":"77","author":"Abul-Hassan HS","year":"1986","unstructured":"Abul-Hassan HS, , von Drasek Ascher G, , Acland RD. Surgical anatomy and blood supply of the fascial layers of the temporal region. Plast Reconstr Surg. 1986; 77(1):17-28. 3941846","journal-title":"Plast Reconstr Surg"},{"issue":"4","key":"e_1_3_1_4_2","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1097\/00001665-199907000-00012","article-title":"Attachment of the deep temporal fascia to the zygomatic arch: an anatomic study.","volume":"10","author":"Hwang K","year":"1999","unstructured":"Hwang K, , Kim DJ. Attachment of the deep temporal fascia to the zygomatic arch: an anatomic study. J Craniofac Surg. 1999; 10(4):342-345. 10686884","journal-title":"J Craniofac Surg"},{"key":"e_1_3_1_5_2","doi-asserted-by":"crossref","unstructured":"Gupta A Malhortra G Akadira O Jackson IT. Head and neck embryology and anatomy. In: Siemionow MZ Eisenmann-Klein M eds. Plastic and Reconstructive Surgery. London England: Springer-Verlog London Limited; 2010:249. Springer Specialist Surgery Series.","DOI":"10.1007\/978-1-84882-513-0_18"},{"issue":"1","key":"e_1_3_1_6_2","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1001\/archfaci.2.1.16","article-title":"Transconjunctival sub-orbicularis oculi fat (SOOF) pad lift blepharoplasty: a new technique for the effacement of nasojugal deformity.","volume":"2","author":"Freeman MS","year":"2000","unstructured":"Freeman MS. Transconjunctival sub-orbicularis oculi fat (SOOF) pad lift blepharoplasty: a new technique for the effacement of nasojugal deformity. 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