The submalar hiatus is a furrow located below the lower orbital arch
it is oblique downwards and outwards
it divides the cheek in two in some patients
it has been well individualized by artists since Antiquity, notably sculptors
some anatomists have called it the midjugal groove
its anatomical structure is very precise, however its origin is debated
some authors attribute to it the melting of the fat located between the external malar fat compartment and the fatty rim parallel to the nasolabial fold
other authors including myself rather invoke localized fat loss associated with a rotation of the nasolabial fat pad downwards and inwards. In fact, there is a center of rotation at the level of each nostril which has a fixed vascular hilum at depth. The submalar hiatus does not in itself constitute a marked ugliness but it can become a concern for certain patients, both women and men. The surgical correction of the submalar hiatus involves the repositioning of the fatty rim by a facelift, the technique of which can vary between a biplane skin+Smas facelift, with re-tensioning of the Smas upwards and outwards
another solution is the medio-facial lifting described by Le Louarn
finally, there is a non-operative solution thanks to aesthetic medicine using a specific injection technique that we describe.