ASF (Anterior Septal Fat)
Malar bags are puffiness in the pre-zygomatic space and are classified as festoons, malar mounds and malar edema. The pathophysiology of malar bags is not well understood nor described. We have treated more than 200 patients with malar bags in the last 14 years. We found the presence of fat deposits below the orbicularis oculi muscle and over the orbital septum, which was different from SOOF (Sub-orbicularis oculi fat). We have named these fat deposits Anterior Septal Fat (ASF).
ASF was seen in both patients with congenital and acquired festoons or malar mounds. Excision of ASF at the time of raising skin/muscle flap, through subciliary incision resulted in better postoperative results.
We would like to do MRI and ultrasound studies of the pre-zygomatic space in patients with festoons and in a control group without festoons. We hope that this study will help with the treatment and correction of extremely difficult festoon cases.
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