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The illustrations on these two pages are derived from the work of D. H. Enlow in Facial Growth and B. H. Broadbent Sr, B. H. Broadbent Jr and W. H. Golden in Bolton Standards of Dentofacial Developmental Growth.

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Soft Tissue

Underlying the skin and overlying the muscles of the face is a layer of subcutaneous fat. Although this is of fairly even thickness over most of the face, there are a number of important cushions of fat which have a profound effect on its surface form.

In the faces of babies there are always 'sucking pads' situated between the masseter and buccinator muscles of the cheek. These act as an aid to suckling, and give the infant face its typical 'chubbiness' . They vanish in later infancy, and pockets of fat begin to form which modify and augment the bone-and-muscle form of the face.

In youth, all body fat is smooth and firm and these pockets merge subtly into one another and into the overall smooth contours of the cheeks and jaw. By the onset of early middle-age they have begun to soften, and they become progressively more clearly defined as separate individual fat deposits.

In the very few investigations into the peculiarities of the human face that have been published, I have found no mention of these as significant factors in differentiating one face from another, so I shall do the following exposition the dubious honour of calling it the Tiner System of Facial Differentiation.

On most faces, a cushion of adipose tissue forms on the upper lateral edges of the mouth sphincter muscles. This adds a small amount of bulk to the front of the face from the sides of the nose downwards to the sides of the mouth. The area it covers varies a little; its general placing is labelled 1 on the diagram. These cushions soften as one gets older, and contribute to the forming of the familiar 'smile creases' known to beauticians as naso-labial lines. For this reason, I shall designate these fat cushions the naso-labial cushions. If large they give an 'apple-cheeked' appearance to the face in youth and, with advancing age, gradually become 'jowls' (examples A).

These naso-labial fat-pockets sometimes extend far enough to merge with another pair, labelled 2 on the diagram. Although some faces show no sign of these at all, others may show a very definite plumpness here (examples B). Continuing with the Latinized nomenclature, I'll call these the /atera/cushions. In later middle-age these, too, contribute to 'jowliness' in overweight people.

The third location for a fat-pad is the most common. Almost every face shows some evidence of flesh on the front of the chin (3). This is termed the mental cushion (from the Latin menta, meaning 'chin'). It sometimes shows a distinct cleft or dimple, which may or may not reflect a small central groove in the jutting lower edge of the jawbone. With the softening and sagging of middle-age, this cushion usually droops down to form the common double-chin.

Fat Pads Hands Palm

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