Is the malaris muscle the anti-aging missing link of the midface?

Abstract

BackgroundThe malaris muscle is a superficial and fine facial muscle. It is not well known because of its inconsistency in Caucasians. It could play a role in midface aging prevention as that observed in subjects with prominent cheekbones like Asian people. The purpose of this study was to explain how the malaris muscle is able to produce an anti-aging effect on the midface.MethodsWe first analysed a hundred pictures of human faces of different age sex and race to better comprehend identifying characteristics of aging in particular of the midface. Then anatomical dissections were done on fresh cadavers to identify the malaris muscle associated with radiological studies. Finally, in vivo experiments with botulinum toxin A (Botox) and lidocaine (Xylocaine) permitted to precise the action of the malaris muscle on the midface and principally on the malar fad pad.ResultsThese anatomical and functional studies demonstrated that the malaris muscle acts as a dynamic link between the Superficial Muscular Aponeurotic System (SMAS) of the upper part of the face and the SMAS of the midface, producing a lifting effect of the soft tissues of the cheek particularly the malar fat pad. This action is the due to presence of the dermal terminations of the malaris muscle.ConclusionsThe malaris muscle could be an anti-aging link of the midface. Our findings suggest a new approach for the comprehension of the global facial aging.