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Anatomy and Tensile Strength of the Zygomatic Ligament

The aim of this study was to elucidate the precise anatomic and histologic structure and tensile strength of the zygomatic ligament (ZL). Nine hemifaces of 7 Korean adult cadavers were dissected, and 5 were prepared for histologic examination. The locations of the bony attachment areas of the ZLs were measured on rectangular and polar coordinates. The x axis was a horizontal line across the lower border of the superficial lateral canthal ligament. The y axis was a vertical line at the lateral border of the orbital rim. The tensile strengths of the ZLs were measured using a force gauge. Each ZL was attached from the zygoma to the dermis. The bony attachment area of the ZL was rectangular shaped. The thickness (mean ± SD) at its origin was 0.8 ± 0.2 mm, and the width was 8.1 ± 0.7 mm with a bone-to-dermis height of 6.5 ± 0.6 mm. The axis was 19 degrees inclined to the horizontal line. The vertical distance from the x axis to the lateral end and to the medial end of the ZL was 23.4 ± 2.1 mm and 26.0 ± 1.3 mm, respectively. The horizontal distance from the y axis to the medial end and to the lateral end of the ZL was 8.3 ± 2.7 mm and 14.9 ± 3.2 mm, respectively. The distance from the origin to the medial end and to the lateral end of the ZL was 28.2 ± 1.6 mm and 28.9 ± 2.6 mm, respectively. The angle between the y axis and the medial and the lateral end of the ZL was 16.4 ± 5.3 degrees and 14.0 ± 1.7 degrees, respectively. The parasagittal section of the cheek skin of the ZL contained an oblique bundle of fibers, which connected the dermis to the periosteum. The breaking strength of the ZL was 26.8 ± 1.8 N (range, 22.5-32.9 N). Knowledge of the location, shape, and mechanical properties of the ZL is essential in face rejuvenation surgery.