Relationship between the retinacula cutis and sagging facial skin

Abstract Background Sagging skin is one of the most concerning esthetic issues for elderly individuals. Although reduced skin elasticity has been reported as the cause of sagging skin, a loss of skin elasticity alone is insufficient to explain sagging facial skin. This study investigated the mechanisms underlying sagging skin, with a focus on the subcutaneous network of collagenous fibers known as the retinacula cutis ( RC ). Methods To evaluate the structure of the RC noninvasively, tomographic images of the face were obtained using magnetic resonance imaging ( MRI ). The RC was identified by comparing MRI results with histological specimens of human skin. A descriptive scale was used to evaluate the degree of sagging, and a device equipped with a 6‐mm‐diameter probe was used to measure the elasticity of deeper skin layers and evaluate the physical properties of the skin. Results The density of RC in subcutaneous tissue correlated negatively with sagging scores and positively with elasticity. Conclusion These results imply that a sparse RC structure contributes to a reduction in the elasticity of subcutaneous tissue, resulting in a greater degree of sagging facial skin. These findings are expected to contribute to the understanding of the mechanisms underlying sagging skin.