LAUSR

BACKGROUND The deep temporal fascia provides anchoring during thread lifting, which is a minimally invasive facelifting procedure. However, anatomic studies involving the deep temporal fascia as well as effective and safe thread lifting procedures are scarce. We clarified the anatomy of the superficial layer of the deep temporal fascia and its surrounding structure using ultrasonography, histologic sections, and cadaveric dissection to propose an effective thread lifting procedure guideline. METHODS We included 20 healthy young South Korean participants. Real-time, two-dimensional, B-mode ultrasonography was performed. Longitudinal scanning was performed along three vertical lines: the line passing through the jugale, the anterior margin of the condylar process of the mandible, and the midpoint between the jugale and anterior margin of the condylar process. Histologic samples from three fresh adult cadavers were harvested from 2.5 cm above and below the zygomatic arch. Eighteen fresh adult hemifaces of South Korean cadavers (six males, three females; age, 67.3 ± 7.2 years) were used to confirm the morphology of the deep temporal fascia. RESULTS The superficial layer of the deep temporal fascia crossed the zygomatic arch and was connected to the origin of the zygomaticus major muscle at the line passing through the jugale. The superficial layer continued inferiorly to the parotidomasseteric fascia at the line passing through the midpoint and condylar process of the mandible. CONCLUSIONS This study yielded the novel anatomy of the superficial layer of the deep temporal fascia, and this anatomic structure may be used for an ideal thread lifting procedure.