Influence of subcutaneous adipose tissue mass on dermal elasticity and sagging severity in lower cheek

Background Subcutaneous adipose tissue lies just beneath the dermal layer, but the interaction between the two is not well understood. Recently, we showed that the subcutaneous adipose layer affects dermal properties in an obese rodent model. Objective To explore the influence of the subcutaneous adipose layer on dermal properties and morphology in humans. Methods Subcutaneous adipose mass was measured by ultrasound using a Prosound alpha 5 (R), dermal elasticity was measured using an in vivo suction skin elasticity meter (Cutometer MPA 580 (R)), and sagging severity were evaluated morphologically using photograph-based grading criteria at the lower cheek in 70 Japanese female volunteers (age; 31-59, BMI; 17.1-36.2). The correlations among the results were examined. Results Thickness of the subcutaneous adipose layer was significantly and negatively correlated with dermal elasticity parameters, i.e., elastic deformation, elastic deformation recovery, extensibility, total deformation recovery, ratio of viscoelasticity to elastic distention and overall elasticity, including creep and creep recovery. Furthermore, we investigated their influence on facial morphology, such as sagging. The subcutaneous adipose mass was significantly and positively correlated with sagging severity at the lower cheek (R=0.442, P < 0.001), and there was a significant negative correlation between dermal elasticity and sagging severity (R=-0.358, P < 0.01). Conclusion These results indicate that increment of subcutaneous adipose mass impairs dermal elasticity, which in turn exacerbates sagging severity.