Anatomical Definition
The prezygomatic space (prezygomatic space) is a virtual space that becomes real during surgical dissection. It is located anterior to the zygomatic arch and represents a transition zone between superficial and deep midface structures.
Anatomical Boundaries
- Superior: Zygomatic arch and temporal fascia
- Inferior: Deep malar fat (SOOF)
- Medial: Zygomatic-cutaneous ligament
- Lateral: Temporal extension of SMAS
- Anterior: Orbicularis muscle and pre-orbicular fat
- Posterior: Zygomatic bone periosteum
Surgical Importance
This space is fundamental in midface rejuvenation techniques because it allows access to structures that need to be mobilized without compromising nerve structures.
Dissection Advantages
- • Relatively avascular plane
- • Nerves remain superficial to the plane
- • Access to deep malar fat
- • Allows ligamentous release
Necessary Precautions
- • Clearly identify boundaries
- • Don’t deepen excessively
- • Respect zygomatic ligament
- • Careful hemostasis
Relationship with Noble Structures
Facial Nerve
The zygomatic and buccal branches of the facial nerve pass superficially** to the prezygomatic space, within or just below the SMAS. Correct dissection in the sub-SMAS plane keeps these nerves protected. Tip: Direct vision allows identifying nerves before any risk of injury.
Facial Vessels
The facial artery and vein pass medially to the prezygomatic space. Perforating branches may be encountered and should be carefully coagulated during dissection.
Application in Endomidface
In Direct Vision Endomidface, the prezygomatic space is accessed through the temporal incision. Dissection progresses from lateral to medial, allowing:
1. SOOF Access
Suborbicularis fat (SOOF) can be mobilized vertically.
2. Ligamentous Release
Zygomatic-cutaneous ligament can be released under vision.
3. Malar Repositioning
Descended malar tissue is elevated with vertical vector.
Frequently Asked Questions
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