Anatomical Foundations
Applied Anatomy
The deep spaces, dissection planes, and noble structures you need to know for safe operation.
Understanding deep anatomy is crucial for Endomidface safety and efficacy. Surgery is performed in delicate planes, near important nerves and vessels. The goal is to access and mobilize pre-zygomatic and pre-maxillary spaces, always keeping the dissector tilted toward the surface.
Anatomical Spaces Addressed
Pre-zygomatic Space
First space accessed. Entry perceived as sudden loss of resistance.
Contents: Pre-zygomatic fat, SOOF
Pre-maxillary Space
Continuation of dissection toward corner of mouth.
Contents: Deep medial fat, malar fat compartments
Buccal Space
Distal limit of dissection. Contains buccal fat pad (Bichat).
Contents: Buccal fat pad
The Golden Rule of Dissection
"Noble structures are below. If I tilt my dissector down and lose the plane, there will be motor injury. If I tilt up and perforate the SMAS, I go to subcutaneous and skin — everything's fine, no permanent damage."
Noble Structures & Protection
| Structure | Location | How to Protect |
|---|---|---|
| Frontal Branch | In temporal space roof, in superficial temporal fascia | Always dissect over deep temporal fascia; place sutures posterior to incision |
| Zygomatic Branches | In floor of pre-zygomatic and pre-maxillary spaces | Tilt dissector toward surface (upward); never go deep |
| Buccal Loop | Below dissection plane, in floor | Stay on SMAS roof; if you perforate to surface, no permanent damage |
| Supraorbital Nerve | At pupil level, superior orbital rim | Sensory nerve, usually visualized; traction may cause transient numbness |