Deep Medial Cheek Fat: Anatomy
- Highlighted area
Quick facts
- Definition
- A deep fat compartment of the midface, resting on the maxilla, beneath the muscles of facial expression.
- Location
- Medial to the medial portion of the SOOF and deep to the nasolabial and medial cheek fat.
- Boundaries
- Above, the region of the orbicularis retaining ligament; medially, the vicinity of the piriform aperture.
- Function
- Gives forward projection to the cheek and support to the superficial fat above it.
- Relevance in HOF
- Its loss of volume deepens the transition between the eyelid and the cheek and reduces support for the nasolabial fold.
The deep medial cheek fat is a fat compartment in the deep plane of the midface, resting on the maxilla and beneath the muscles of facial expression. It gives projection to the front of the cheek and serves as the base for the superficial fat above it, such as the nasolabial compartment. In the literature it is often abbreviated DMCF. Its loss of volume is one of the pieces of aging in the cheekbone area.
Where is the deep medial cheek fat?
The face has superficial and deep fat compartments, separated by septa and by muscles, as explained in fat pads and layers of the face.
| Reference | Relation to the deep medial fat |
|---|---|
| Above | Region of the orbicularis retaining ligament, at the transition to the lower eyelid |
| Lateral | Medial portion of the SOOF, the fat under the orbicularis oculi |
| Medial | Vicinity of the piriform aperture, at the base of the nose |
| Superficial | Lip elevator muscles and, above them, the nasolabial and medial cheek fat |
| Deep | Periosteum of the maxilla |
Some authors split the compartment into a medial part and a lateral part, and the exact boundaries vary between studies and between people.
What happens to it with aging?
With age, the compartment tends to lose volume, while the maxilla also undergoes bone resorption. The anterior cheek gets flatter, the transition between eyelid and cheek lengthens, and the tear trough and the midcheek groove appear or deepen. Without the deep support, the superficial fat descends and weighs on the nasolabial fold.
Why does it matter in HOF?
- Midface support: restoring volume in the deep plane of the anterior cheekbone is one of the approaches considered to recover projection, at the professional's discretion. See cheekbone filler.
- Tear trough and fold: part of the look of the under-eye hollow and of smile lines comes from this loss of support, not only from the area where the shadow shows. See under-eye circles: types and assessment.
- Expectation: deep volume improves contour and shadow, but does not treat skin laxity or eyelid fat pads.
How does it show up in the assessment?
- Oblique view: flattening of the anterior cheek and loss of the curve between eyelid and cheekbone.
- Rest vs smile: when smiling, the cheek rises and the loss of deep volume may be less visible.
- Light from above: shadows in the tear trough and the midcheek groove.
Also called: deep medial cheek fat, DMCF, deep medial cheek pad, medial deep malar fat.
Frequently asked questions
What is the deep medial cheek fat?
It is a fat compartment resting on the maxilla, beneath the muscles of facial expression. It gives projection to the front of the cheek and supports the superficial fat compartments.
Why does deep cheek fat matter for filler?
Because loss of volume in this compartment is one of the causes of flattening of the anterior cheek and of deepening of the tear trough and the nasolabial fold. Restoring deep support is one of the approaches considered, at the professional's discretion.