Aesthetic Plastic Surgery

, Volume 43, Issue 1, pp 83–90 | Cite as

Patterns of Superficial Midfacial Fat Volume Distribution Differ by Age and Body Mass Index

  • Jacob I. TowerEmail author
  • Kimberly Seifert
  • Boris Paskhover
Original Article Facial Surgery



The changes that occur to midfacial fat with increasing age and BMI are poorly understood. The aim of this study was to determine how superficial cheek fat volume and distribution are differentially predicted by changes in BMI versus age.


We conducted a retrospective observational study of patients with facial computed tomography scans. Superficial cheek fat volumes were measured, and multiple linear regression analysis was performed to model the relationships between cheek fat and corresponding sex, age, and BMI data.


A total of 109 patients were included in our analysis (51 male, 58 female). The subjects’ ages ranged from 21.7 to 91.1 years with a mean (SD) age of 59.7 (15.0) years. The mean (SD) superficial cheek volume of the subjects was 10.46 (2.57) cc. Female subjects had a significantly greater mean total superficial cheek fat volume compared to male subjects (11.18 cc vs. 9.64 cc; P < 0.001). The results of multiple linear regression analysis indicated that together, age, sex, and BMI explained 50.8% of the variance in cheek fat volumes (R2 = 0.51, P < 0.001). BMI significantly predicted total cheek fat volume (β = 0.239, P < 0.001), in addition to age (β = 0.029, P < 0.017) and sex (β = − 1.183, P = 0.001; female = 0, male = 1). Age predicted the greatest gain of fat in the caudal subdivision of cheek (β = 0.015, P < 0.001), whereas BMI predicted the greatest gain in the cephalad subdivision (β = 0.106, P < 0.001).


Age, sex, and BMI are important predictors of midfacial fat volume. This study shows that increases in age and BMI differentially predict the distribution of superficial cheek fat.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors


Aging Cheek Fat Face Facial rejuvenation Computed tomography 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  • Jacob I. Tower
    • 1
    Email author
  • Kimberly Seifert
    • 2
  • Boris Paskhover
    • 3
  1. 1.Department of Surgery, Section of OtolaryngologyYale School of MedicineNew HavenUSA
  2. 2.Department of Radiology and Biomedical ImagingYale School of MedicineNew HavenUSA
  3. 3.Department of Otolaryngology – Head and Neck SurgeryRutgers New Jersey Medical SchoolNewarkUSA

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