A Novel Subclassification of Type 2 Dermal Insertion Structures
3
Issued Date
2025-01-01
Resource Type
ISSN
10760512
eISSN
15244725
Scopus ID
2-s2.0-105005453707
Pubmed ID
40354671
Journal Title
Dermatologic Surgery
Rights Holder(s)
SCOPUS
Bibliographic Citation
Dermatologic Surgery (2025)
Suggested Citation
Yi K.H., Wan J., Yoon S.E., Jitaree B., Kim H.J. A Novel Subclassification of Type 2 Dermal Insertion Structures. Dermatologic Surgery (2025). doi:10.1097/DSS.0000000000004661 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110380
Title
A Novel Subclassification of Type 2 Dermal Insertion Structures
Author(s)
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND Current anatomical classifications inadequately represent dermal insertion structures critical to facial movement, support, and aesthetic outcomes. Particularly, Type 2 structures—defined by direct connections to the dermis—lack precise subclassification. OBJECTIVE To introduce and validate a novel subclassification system for Type 2 dermal insertion structures based on their origin, composition, and clinical relevance in aesthetic and reconstructive procedures. MATERIALS AND METHODS Detailed cadaveric dissections (n 5 20 hemifaces) were conducted to evaluate the microarchitecture and insertion patterns of muscles and ligaments associated with dermal anchoring. Structures were categorized into 4 subtypes based on anatomical origin and fiber composition. RESULTS Four distinct subtypes were identified: Type 2a (muscle fibers directly inserting into dermis), Type 2b (muscle–collagen transitions), Type 2c (true ligaments anchoring dermis to bone or fascia), and Type 2d (retaining ligaments from intermediate layers). This classification enhances anatomical precision, improves procedural safety, and guides intervention strategies in injectable, thread-based, and surgical techniques. CONCLUSION The proposed Type 2 subclassification provides a clinically meaningful framework for understanding dermal insertions. It supports personalized aesthetic planning and dynamic facial rejuvenation by integrating structural anatomy with procedural targeting.