ANATOMICAL AND FUNCTIONAL ORGANIZATION OF THE MUSCULAR APONEUROTIC CERVICOFACIAL SYSTEM

Monica Mihaela Scutariu, Delia Hînganu, Georgiana Macovei, Marius Valeriu Hînganu

ABSTRACT  Superficial muscular aponeurotic system (SMAS) is a musculoskeletal sheath extending from the frontal muscle to the platysma and it acts as a “contraction amplifier of the facial muscles”. SMAS action is to transmit muscular contraction to the skin: each muscle contraction follows a preferential direction in the network. The aim of this study is to highlight anatomical-functional features of SMAS, which can be applied in buccoomaxilofacial and aesthetic surgery. The study was conducted on 12 cephalic extremities, meticulously dissected in the “Ion Iancu” Anatomy Institute of “Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania. On each stage of dissection, mesoscopic images were captured using the Kaps SOM 62 operating microscope. SMAS presents two parts in continuity with each other: cervicofacial, with predominantly aponeurotic structure and cervical, with essentially muscular structure. We highlighted through dissections the existence of cervicofacial SMAS, its limits, as well as the neighboring relations with the fasciae and vasculonervous elements which are important from a surgical point of view. Knowing regional SMAS can have a great applicability in surgical practice, especially in pathological interventions in the buccomaxilofacial field, but also in surgery for facial rejuvenation. 

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