Anatomical Regions of the Face
The face is systematically organized into distinct anatomical regions that can be understood through multiple frameworks: horizontal thirds (upper, middle, lower), specific fat compartments, muscular layers, and key surface landmarks.
Horizontal Division of the Face
The face is conceptually divided into three horizontal thirds for clinical assessment and treatment planning 1:
- Upper third: Corresponds to the bony pyramid and forehead region, including the glabella 1
- Middle third: Encompasses the dorsal septum, conjoined upper lateral cartilages, midface structures including the zygoma, naso-orbital-ethmoid region, and maxilla 1
- Lower third: Corresponds to alar cartilages, caudal septum, alar base, jawline, and chin regions 1
Key Surface Landmarks and Reference Points
When assessing facial anatomy, specific landmarks serve as consistent reference points 1:
- Facial centerpoint: Located halfway between the medial canthi, serving as the most consistent reference point in anterior-posterior view 1
- Midline vertical: Intercepts the glabella, nasal dorsum, nasal tip, columella base (nasal spine), philtrum, upper incisors, and menton 1
- Medial canthi: Define position and width of nasal bones and alar base 1
- Lateral canthi: Should lie perpendicular to the midline vertical 1
- Alar base and lateral commissure: Should be perpendicular to the midline vertical 1
Fat Compartment Regions
The face contains well-defined, uniform fat compartments in specific regions 2:
- Glabellar region: Contains the glabellar fat pad 2
- Temporal region: Contains the temporal fat pad 2
- Periorbital region: Includes SOOF (suborbicularis oculi fat) 2
- Malar region: Contains the malar fat pad in the upper cheek 2
- Cheek regions: Divided into anterior cheek (nasolabial) compartment, posterior cheek compartment, and lower cheek (jowls) compartment 2
- Jaw-chin area: Includes pre-mental and pre-platysmal fat pads 2
- Nasolabial folds: Distinct high-fat compartment region 2
Muscular Organization
The face contains 30 different muscles organized into three distinct planes 2:
- Superficial muscle plane: Outermost muscular layer 2
- Middle muscle plane: Intermediate muscular layer 2
- Deep muscle plane: Deepest muscular layer 2
Layered Anatomical Framework
The face is arranged in five distinct layers from superficial to deep 3:
- Layer 1: Skin 3
- Layer 2: Subcutaneous fat including retinacula cutis (fibrous connective tissue) 3
- Layer 3: Superficial musculo-aponeurotic system (SMAS) 3, 4
- Layer 4: Deep fat compartments 3
- Layer 5: Periosteum or deep fascia 3
Innervation Territories
The face is divided into sensory innervation regions supplied by the trigeminal nerve branches 2:
- Upper face region: Innervated by V1 ophthalmic nerve, exiting via supraorbital foramen 2
- Midface region: Innervated by V2 maxillary nerve, originating from infraorbital foramen 2
- Lower face region: Innervated by V3 mandibular nerve, covering mandibular and temporal regions 2
Clinical Regions Prone to Aging Changes
Specific facial regions demonstrate characteristic age-related changes 2:
- Periorbital region: Includes supraorbital hollowness, infraorbital hollowness (tear trough deformity), and dark circles 2
- Glabellar region: Develops glabellar lines 2
- Eyebrow region: Shows ptosis (sagging) 2
- Nasolabial region: Develops deep nasolabial folds 2
- Perioral region: Shows wrinkles around the mouth (smoker's lines), loss of lip volume, and perioral wrinkles 2
- Lower face: Develops drooping corners of the mouth, jowls (marionette lines), and irregular chin contour 2
Important clinical note: Regions with minimal superficial fat layers (periorbital and perioral areas) show visible signs of aging earlier than other facial regions, making them priority areas for rejuvenation strategies 2.