Ogee curve
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The Ogee curve is a characteristic, double-curved contour of the midface, best visible in an oblique view, at an angle of approximately 45 degrees. It is formed by gentle transitions between the temporozygomatic region, the cheek convexity, and the submalar depression. The course of the curve depends on the structure of the zygomatic bones and the maxilla, the distribution of deep and superficial fat compartments, the tension of the retaining ligaments, muscle volume, and skin quality. A distinct Ogee curve is associated with good projection of the midface and harmonious light distribution. However, it does not constitute an independent indicator of age, health, or attractiveness, and its shape shows significant individual, sex, and population differences.
Ogee curve - what is it
The name “Ogee” derives from architecture and denotes a line formed by two arcs with opposing directions of curvature. In reference to the face, the term describes a three-dimensional contour rather than a single wrinkle, fold, or anatomical structure. The curve is revealed through the alternating presence of convexities and concavities that reflect light in a specific way.
Its morphology is primarily shaped by:
- the facial skeleton, especially the zygomatic bone, zygomatic arch, maxilla, and inferior orbital rim;
- deep fat compartments, including the deep medial cheek compartment and the fat located beneath the orbicularis oculi muscle;
- superficial cheek fat compartments, separated by connective tissue septa;
- facial retaining ligaments, including the zygomatic ligaments and the orbicularis retaining ligament;
- the musculoaponeurotic system, including the orbicularis oculi muscle, zygomaticus muscles, and the superficial musculoaponeurotic system (SMAS);
- the skin, whose thickness, elasticity, and collagen content influence the visibility of deeper contours.
The Ogee curve does not have a single universal, correct value or shape. Its assessment remains primarily an element of facial morphological analysis. It should take into account symmetry, the proportions of all facial thirds, gender, ethnicity, age, and the patient's natural anatomy. Excessive prominence of the zygomatic region is not synonymous with proper reconstruction of the curve.
Ogee curve - where does it run on the face
The Ogee curve is primarily evaluated in the oblique projection, because the en face view does not fully show the three-dimensional projection of the cheek. Its description in the literature is not entirely uniform. It is most commonly accepted that the line begins in the lateral part of the forehead or temple, passes through the zygomatic arch area and the maximum convexity of the cheek, and then gently changes direction in the submalar region.
Within the midface, one can distinguish:
- a gentle temporo-prezygomatic concavity;
- a zygomatic-malar convexity, formed by the bony projection and the overlying soft tissues;
- a subtle submalar concavity, separating the cheek from the lateral part of the lower face.
The maximum cheek projection should not be automatically equated with the most lateral point of the zygomatic bone. Its position results from the sum of bony projection, soft tissue volume, and the direction of incident light. In a youthful face, the transition between the lower eyelid and the cheek is usually smoother, and the cheek convexity is located relatively high. With age, flattening of the anterior cheek, lengthening of the lid-cheek junction, deepening of the tear trough and the nasolabial fold, as well as the formation of irregular shadow zones are more commonly observed.
Facial expression also influences the appearance of the curve. Smiling displaces cheek tissues superiorly and laterally, which is why the assessment is performed both at rest and during animation. Photography should be standardized in terms of head angle, focal length, distance, lighting, and expression. Otherwise, shadow or perspective distortion may be mistakenly interpreted as an actual anatomical change.
Ogee curve - why it disappears with age
The flattening of the Ogee curve is the result of multi-layered facial aging. It is not solely caused by gravitational "skin sagging". Changes occur simultaneously in the skeleton, fat compartments, ligaments, muscles, and skin, with their rate and severity being individual.
The most important mechanisms include:
- bone remodeling: with age, maxillary retrusion, a reduction in its projection, widening of the pyriform aperture and orbit, as well as changes to the inferior orbital rim may occur. This weakens the support for the midface tissues;
- changes in deep fat compartments: their deflation reduces the internal support of the cheek and flattens its anterior projection;
- uneven changes in superficial fat: some compartments lose volume, while others may retain it, shift, or become relatively prominent. A pattern of adjacent "hills and valleys" is formed;
- alteration of ligament and septal properties: limited elasticity and weakening of the support system promote tissue displacement;
- skin aging: the content and quality of collagen, elastin, glycosaminoglycans, and lipids decrease. The skin becomes thinner, less resilient, and less adapted to the changing scaffold;
- photoaging and environmental factors: ultraviolet radiation, tobacco smoking, chronic oxidative stress, and pollution accelerate the degradation of the extracellular matrix;
- hormonal and metabolic changes: the decline in estrogen levels after menopause can exacerbate collagen loss and bone changes;
- rapid weight reduction: significant loss of adipose tissue, including during incretin-based drug therapy, can accentuate temple and cheek hollowing as well as excess lax skin.
Consequently, the cheek convexity descends or flattens, the submalar hollow becomes irregular, and the junction between the lower eyelid and the cheek becomes more pronounced. At the same time, the tear trough and nasolabial folds may deepen. However, not everyone experiences the classic "loss" of the curve. In some patients, superficial tissue heaviness, malar edema, or naturally weaker bony projection predominate.
Ogee curve - how to restore it
Restoration of the Ogee curve should result from the diagnosis of the dominant layer of the problem, rather than from mechanical cheekbone augmentation. The assessment includes bone projection, deficits in individual fat compartments, tissue mobility, skin laxity, the eyelid-cheek area, and chin and mandibular proportions. Documentation in frontal, lateral, and oblique views is also indicated.
At Ambasada Urody Clinic & Spa, the following methods are available to be part of an individually planned correction:
- Volumetric lifting and facial contouring with cross-linked hyaluronic acid: structural products can restore deep support points, zygomatic projection, and cheek volume. More flexible products are used in more mobile or superficial layers. The effect is immediately visible, but it is ultimately evaluated after the swelling subsides and the product integrates with the tissues.
- Calcium hydroxyapatite and hybrid fillers: combine a limited structural support effect with collagen biostimulation. They can improve tissue contour and quality, but are not an equivalent to a classic filler in every anatomical location.
- Tissue stimulators, including products containing poly-L-lactic or poly-D,L-lactic acid, polynucleotides, and other biostimulatory substances: induce gradual remodeling of the extracellular matrix. Their primary task is to improve tissue density and elasticity, rather than precise, immediate reconstruction of bony projection.
- Autologous fillers, such as platelet-rich plasma, fibrin, and plasma gel: support repair processes and can provide subtle tissue redensification. The volumetric effect is usually smaller and less predictable than with structural products.
- PDO, PLLA, or PCL lifting threads: can mechanically reposition moderately sagging tissues. However, they do not restore bone resorption or deep fat compartments, and the outcome depends on tissue thickness, quality, and weight.
- SonoQueen HIFU: focused ultrasound creates controlled thermal coagulation points and collagen remodeling at a selected depth. The method can improve firmness in cases of laxity, but it does not restore lost volume. In individuals with thin faces, the parameters require particular caution.
- Microneedle radiofrequency and classic RF radio waves: controlled heating of the dermis initiates healing and neocollagenesis. These treatments primarily serve to redensify and improve skin tightness.
- Zaffiro and Palomar Deep IR: infrared thermolifting acts on the dermis, supporting its contraction and collagen remodeling.
- Fractional lasers: improve the structure, density, and quality of the skin surface, but alone do not restore the deep convexity of the cheek.
- Needle mesotherapy, peels, massages, endermologie, Icoone, cryoplasty, and cosmetic treatments: can support hydration, microcirculation, and skin quality, but do not reconstruct the lost bone scaffolding or significant fat deficits.
In cases of significant tissue sagging, a surgical midface lift or facelift, sometimes combined with fat transfer, may be the most effective method. Non-surgical procedures are not an equivalent replacement for it.
The correction should be performed by a physician with a thorough knowledge of facial vascular anatomy. Filler injections may cause swelling, hematomas, infection, nodules, asymmetry, and product migration, and rarely, vascular occlusion, skin necrosis, visual impairment, or stroke. In the case of hyaluronic acid products, it is essential to have a protocol for the immediate treatment of vascular complications with hyaluronidase. A safe goal of therapy is the restoration of proportions and smooth anatomical transitions, not maximizing cheek volume.
