Superficial and deep fat pads
The fat tissue in the face consists of two layers: superficial (subcutaneous) and deep (subSMAS). Superficial fat is usually not a smooth and continuous layer, but separate compartments—separated by septal boundaries. Deep fat, on the other hand, is located under the SMAS, closer to the bone, and serves as "structural support."
Midface compartments
The main pads in the midface are: Nasolabial Fat Pad (in the nasolabial fold), Medial Cheek Fat, Middle Cheek Fat, Lateral Cheek Fat. Additionally, there is the deep Deep Medial Cheek Fat (DMCF)—this pad provides the apple cheek volume of a young face. Ristow's space is a small deep pad around the edge of the nose; a small filler placed here gives dramatic volume to the midface.
Temporal region and periorbital area
The fat in the temples (temporal fat pad) is a pad with a high risk of melting. When it melts, a "hollow temple" appearance occurs, and the face looks aged in turn. Around the eyes, there are infraorbital (under-eye), malar, and SOOF (suborbicularis oculi fat) pads. The "tear trough" under the eye is formed as a result of the thinning and displacement of these pads.
Lower face and chin
Jowl (chin sagging) is actually the result of superficial fat sliding down with SMAS loss—when this sliding gets caught on a fixed ligament (mandibular ligament), a hollow forms in front of that point and a bulge behind it. The disappearance of the jawline is the image of this mechanism.
Clinical note:When performing filler injections, it is important to place it not in the "pad" but in the "deep anchor of the pad." Superficial injections provide temporary improvement; injections into deep anchorage points provide structural support that will last for years.
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Facial Anatomy: The Essential Map for Aesthetic Practice