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Special Topics | ONLINE FIRST

Biomechanical Properties of the Facial Retaining Ligaments

Michael G. Brandt, HBSc, MD; Agnieszka Hassa, BSc, MD; Kathryn Roth, MD; Bret Wehrli, MD; Corey C. Moore, MD, MSc, FRCSC
Arch Facial Plast Surg. 2012;14(4):289-294. doi:10.1001/archfacial.2011.1533.
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Objective Osteocutaneous facial retaining ligaments play an important role in the aging face. We sought to better characterize the biophysical properties of these ligaments and, in doing so, provide an empirical basis for the natural descent seen in facial aging.

Methods Five fresh frozen cadaver heads yielding 10 hemifaces were dissected to expose the orbital, zygomatic, buccomaxillary, and mandibular osteocutaneous ligaments. Each ligament was assessed and subjected to biomechanical testing. The main outcome measures included ligament dimensions, stiffness, percentage of elongation, and force to initial and ultimate failure.

Results Initial and ultimate failure testing revealed the zygomatic ligament to be strongest, followed by the orbital, mandibular, and maxillary ligaments. The zygomatic ligament was also stiffest, followed by the orbital, maxillary, and mandibular ligaments. The percentage of elongation acted as a surrogate marker of elasticity, with the greatest elasticity maintained by the mandibular ligament, followed by the orbital, zygomatic, and buccomaxillary ligaments. Ligament dimensions and biophysical properties did not vary relative to cadaveric hemiface, age, or sex.

Conclusions To our knowledge, this is the first investigation to quantify the biomechanical properties of the facial retaining ligaments. Inherent ligament properties seem to be related to the changes observed in facial aging, although further study is required.

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face ; ligaments

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Figure 1. Sample force (N) vs displacement (in millimeters) curves obtained for a single cadaver tested. The gray arrow indicates the point of initial failure, the black arrow indicates the point of ultimate failure. A, Orbital ligament; B, zygomatic ligament; C, maxillary ligament; D, mandibular ligament.

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Figure 2. Average load until failure for the facial retaining ligaments. Light gray bars correspond to mean forces (N) exerted on the ligaments prior to initial failure, and dark gray bars correspond to mean forces (N) exerted on the ligaments at ultimate failure. Error bars identify maximal and minimal 95% CIs.

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