SUBCUTANEOUS ADIPOSE FIBER - loose connective tissue with fatty deposits that connects the skin to deeper tissues. It forms subcutaneous cellular spaces, in which there are terminal sections of sweat glands, vessels, lymph nodes, skin nerves.

Anatomy and histology

The basis of the PZhK is made up of connective tissue fibrous cords formed by bundles of collagen fibers mixed with elastic fibers (see Connective tissue), originating in the reticular layer and going to the superficial fascia, which delimits the PZhK from the underlying tissues (proper fascia, periosteum, tendons). According to the thickness, fibrous cords of the 1st, 2nd and 3rd order are distinguished. Between the strands of the 1st order there are thinner strands of the 2nd and 3rd order. Cells bounded by fibrous bands different order, completely filled with lobules of adipose tissue, forming fatty deposits (panniculus adiposus). The structure of PLC determines its mechanical properties - elasticity and tensile strength. In places subject to pressure (palm, sole, lower third of the buttocks), thick fibrous bands predominate, penetrating the subcutaneous tissue perpendicular to the surface of the body and forming skin retainers (retinacula cutis), which tightly fix the skin to the underlying tissues, limiting its mobility. Similarly, the skin of the scalp is connected to the tendon helmet. Where the skin is mobile, fibrous bands are located obliquely or parallel to the surface of the body, forming lamellar structures.

In the body of an adult, they average approx. 80% of the total mass of pancreas (the percentage varies greatly depending on age and gender and body type). Adipose tissue is absent only under the skin of the eyelids, penis, scrotum, clitoris and labia minora. Its content is insignificant in the subcutaneous base of the forehead, nose, outer ear, lips. On the flexor surfaces of the limbs, the content of adipose tissue is greater than on the extensor ones. The largest fat deposits are formed on the abdomen, buttocks, in women also on the chest. There is a close correlation between the thickness of the SFA in various segments of the limbs and on the trunk. The ratio of the thickness of the pancreas in a man and a woman is on average 1: 1.89; its total weight in an adult man reaches 7.5 kg, in a woman 13 kg (respectively 14 and 24% of body weight). In old age, the total mass of adipose tissue under the skin decreases and its distribution becomes disproportionate.

In some parts of the body, muscles are located in the pancreas, during the contraction of which the skin in these places gathers into folds. Striated muscles are located in the subcutaneous tissue of the face [facial muscles (facial muscles, T.)] and neck (subcutaneous muscle of the neck), smooth muscles - in the subcutaneous base of the external genital organs (especially in the fleshy membrane of the scrotum), anus, nipple and areola of the mammary gland.

The pancreas is rich in blood vessels. Arteries, penetrating into it from the underlying tissues, form a dense network on the border with the dermis. From here, their branches go in fibrous cords and divide into capillaries surrounding each fatty lobule. In the pancreas, venous plexuses are formed, in which large saphenous veins are formed. Limf, PZhK vessels originate in deep limf, networks of skin and go to regional limf, nodes. The nerves form a wide-loop plexus in the deep layer of the pancreas. Sensitive nerve endings are represented in the subcutaneous tissue by lamellar bodies - bodies of Vater - Pa-chini.

Physiological significance

Functions of PZhK are diverse. The external shape of the body, turgor and skin mobility, the severity of skin furrows and folds largely depend on it. PZhK is the energy depot of the body and is actively involved in fat metabolism; it plays the role of a thermal insulator of the body, and brown fat, found in fetuses and newborns, is an organ of heat production. Due to its elasticity, the PZHK performs the function of a shock absorber of external mechanical influences.

The study of subcutaneous fat allows you to assess the degree of its severity, the uniformity of distribution throughout the body, to identify the presence of edema.

To assess the severity of the subcutaneous fat layer, a slightly deeper palpation is required than in the study of the skin. Thumb and forefinger right hand capture in the fold not only the skin, but also the subcutaneous tissue. The thickness of the subcutaneous fat layer should be determined not in any one area, but in different places, since in pathological cases the deposition of fat in different places is not the same.

The thickness of the subcutaneous fat layer is determined in symmetrical areas in the following sequence: first on the abdomen - at the level of the navel and outside of it (along the outer edge of the rectus abdominis muscle), then on the chest at the edge of the sternum, on the back - under the shoulder blades, on the extremities - the inner the surface of the shoulder and thigh and, finally, on the face - in the cheek area.

With a normal degree of severity, the thickness of the skin fold is 1.5-2 cm. With a fold thickness of less than 1.5 cm, an insufficient degree of development of the subcutaneous fat layer is ascertained, and with a fold thickness of more than 2 cm, an excessive severity of the development of the fat layer (obesity). With a pronounced underdevelopment of the subcutaneous tissue (cachexia), the thickness of the skin fold is less than 0.5 cm (almost the thickness of the skin).

The distribution of the fat layer throughout the body can be uniform (mainly when overeating) and uneven with the predominant deposition of fat in certain places. Usually, an uneven distribution of the subcutaneous fat layer occurs when the function of the endocrine glands is impaired.

Edema- this is the accumulation of fluid in the subcutaneous fat and tissues due to the flow of the liquid part of the blood through the wall of the capillaries. The accumulated fluid may be of inflammatory, allergic origin (exudate), or may occur as a result of blood stagnation in diseases of the heart, kidneys (transudate), metabolic disorders. By prevalence, general, local and latent edema are distinguished.

General edema characterized by distribution throughout the body (often reaching the degree of anasarca) or occur in symmetrical areas (face, lower limbs). They develop as a result of diseases of the heart, kidneys, as well as with prolonged starvation.

According to the severity, the following types of edema are distinguished:

1) pastiness - slight swelling that is not detected during examination, while pressure reveals a barely noticeable hole;

2) pronounced edema , determined by eye, are characterized by swelling, tension and smoothness of the skin, as well as the smoothness of the external contour of this part of the body; when pressed, a sufficiently deep hole is revealed;

3) anasarka - these are massive edema of the subcutaneous fat of the whole body with accumulation of fluid also in the cavities (abdominal, pleural, cavity of the heart shirt).

local edema arise as a result of local disorders of blood and lymph circulation, as well as due to inflammatory or allergic lesions. They are observed with limited inflammatory processes, allergic reactions(Quincke's edema), blockage of a vein by a thrombus (phlebothrombosis), lymphostasis.

So called hidden swelling are observed in the early stages of true edema, when 2-4 liters of fluid can accumulate in the interstitial space imperceptibly. Clinically manifested by weight gain, decreased diuresis. Hidden edema is detected by systematic weighing, measuring daily diuresis, as well as conducting special tests to identify "edematous readiness" of the tissue (McClure-Aldrich test).

Where and how is fat found?

All fat mass is usually divided into three layers, which differ from each other not only in localization, but also in the features of the exchange.

1st layer - the most superficial. This is subcutaneous fat. Located between the skin and the shell; muscles. The harmony of the outlines and proportions of the figure depends on its condition. It is located on all parts of the body without exception, varying significantly in density and thickness. It is in this layer that cellulite can occur. The amount of the first layer is determined by the thickness of the fat fold. You can do a simple pinch test yourself. With two fingers in a standing position, grab a layer of fat where you want, for example, on the stomach. The distance between the fingers will characterize the thickness of the surface layer of fat.

Paradoxically, getting rid of fat deposits in this layer is easier than getting rid of fat from another localization. Therefore, if the distance between your fingers reaches a significant size, you can rejoice - this fat will most likely be able to “melt” quite easily.

2nd layer - deep. It is located under the muscular fascia, as if between the muscles. The main feature of this layer is that it is little subject to reduction with a general reduction in weight. Intense and irregular physical activity, mixed with periods of overeating, contributes to the deposition of fat between the muscles. Sumo wrestlers and bacon pigs have a lot of such fat.

3rd layer - inner (visceral). located inside abdominal cavity. The pronounced hypertrophy of this layer is more typical for men, which is expressed in the form of large, bulging, elastic bellies. With the well-known “beer belly” syndrome, the layer of adipose tissue between the fingers during the pinch test can reach only 2 cm, therefore, the bulk of the fat deposits is the fat of the 3rd, deep layer.

AT recent times quite common and popular methods surgical removal of fat - various types of liposuction. In this case, liposuction is carried out only in the surface layer - subcutaneous fatty tissue. In this layer, fat does not really accumulate in the future. But if you continue to eat improperly, lead a sedentary lifestyle, fat will begin to accumulate in the inner layers - in the 2nd and 3rd.

The appropriateness and safety of liposuction is debated, but it is clear that the problems overweight she can't decide. Moreover, the massive destruction of the surface layer in violation of fat metabolism provokes the deposition of fat between the muscles and in the abdominal cavity. This greatly complicates the work of correcting the figure and generates noticeable disproportions.

Types of fat distribution - pear or apple?

Experts call the deposition of fat according to the male type, "apple", - abdominal (or android, central), according to the female type, "pear", - gynoid (gluteal-femoral). There is also a mixed type of fat deposition. The ratio of waist circumference to hip circumference characterizes the type of fat deposition. The value of OT / OB, exceeding 1.0 for men and 0.85 for women, indicates an abdominal type of obesity. What to do, nature has so ordered that fat deposits in men and women are deposited in different places. In women - primarily in the waist, buttocks and hips. In men - mainly in the upper body, shoulders, chest, abdomen. But that doesn't mean women can't store apple fat. This is quite possible. The distribution of adipose tissue is genetically mediated. In addition, menopausal women may develop male-type abdominal obesity.

If "apple" is your silhouette, we can assume that you are lucky to some extent, since fat deposits of this type go away easier and faster. But, truth, faster and recruited. The exception is abdominal-visceral obesity, that is, the accumulation of fat in the abdominal cavity. This fat is the slowest to undergo lipolysis.

If your figure is more like a pear- get ready for a long and stubborn struggle for the harmony of the hips. Fat deposits of this type are extremely stable. But if you still managed to solve this problem, the result will please you for a long time. True, on one condition. What? I think you already guessed. Of course, in any case, after achieving a positive effect, supportive procedures are needed.

Problem areas

Almost every woman can determine where her problem areas are.. These are the areas that manage to gain weight first and lose weight last. Sometimes my patients warn me at the very first visit to the office: “I am afraid to use diets, because my face immediately becomes emaciated and my chest sinks.”

It is in this case hardware therapy allows you to achieve good results. Women of the "pear" type are well aware of the phenomenon - when losing weight, fat first disappears from the cheeks and the chest disappears somewhere, and only after incredible efforts can fat deposits on the hips be reduced.

In women of the "apple" type, arms and legs are the first to lose weight., and the dense tummy and sides remain round for a long time.
Thus, any diet or severe dietary restrictions can negatively affect the appearance. Weight fluctuations increase the disproportion - each new weight loss-gain cycle leaves extra pounds in problem areas.

Unlike diets, as well as drugs for the treatment of cellulitethat prevent the absorption of fat and reduce appetite, hardware methods delicately act on disproportionate figures. Hardware cosmetology the good thing is that it can act locally. For example, only on the hips. And the hips will, faster or slower, “pull up” and decrease in volume, while other parts of the figure that do not need correction will not suffer.

Author of the article AUNA Professional team

The volume of subcutaneous fat is concerned about most of the world's population. This structural layer is located just under the skin, so it can be felt when touched. The upper parts of the adipose tissue are permeated with collagen fibers, forming a network of loops. Inside these loops are lobules, which are formed by round cells of adipose tissue containing animal fat. The subcutaneous mass plays the role of a natural shock absorber and heat insulator, but not only (the functions of the subcutaneous tissue will be discussed below).

On the human body, fat is present in large quantities (tens of kilograms) and is unevenly distributed. It depends not only on gender, but also on the type of figure. In women, fatty tissue occupies mainly the buttocks, thighs, and in men - the abdomen and chest. The ratio of the weight of adipose tissue to the total weight of a woman is about 25%. On the male body, this figure is lower - 15%. The fat tissue is thickest in the area of ​​the hips (5 or more centimeters), abdomen, and chest. The thinnest layer of fat can be found on the eyelids, genitals.

Functions of adipose tissue

As already mentioned, subcutaneous fat is not limited to two functions. Its range of tasks includes many aspects. Adipose tissue does the following:
1. Stores and delivers energy at the right time
Fat is a super-energy-intensive substrate. When oxidized, only 1 gram gives 9 kilocalories - energy, which is enough to overcome several tens of meters, and at a fairly fast pace.

2. Serves as a thermal insulation material
In the body of a living being, adipose tissue prevents the release of internal heat to the outside. This aspect is very important when being in the cold, especially for those who live in the north. However, an excess of subcutaneous fat negatively affects health, causing atherosclerosis, hypertension, diabetes and deforming osteoarthritis. In addition, excess fat gives the body an unaesthetic appearance.

3. Protects internal organs
Due to the subcutaneous layer of fat, shocks are softened, the impact is neutralized high temperature. Thus, it protects the internal organs. Having a soft bottom layer, the skin can be mobile - it shifts in all directions. This ability of fatty tissue is needed to protect the skin from damage.

4. Accumulates useful substances
The function of subcutaneous adipose tissue is also accumulation: it absorbs estrogen hormones, retinol, vitamins A, E. This explains the fact that obese men have reduced testosterone levels.

5. Produces hormones
Adipose tissue is an amazing material, because it not only accumulates hormones, but also synthesizes them. Of course, we are talking about estrogens - female sex hormones. The more fat in the body, the higher the level of estrogen.

Synthesis of hormones is carried out with the participation of aromatase - an enzyme contained in fat cells. According to the content of this enzyme, in the first place is subcutaneous tissue buttocks and thighs.

In addition to estrogens, fat produces leptin, the hormone responsible for feeling full. With the help of leptin, the body must regulate the amount of fatty tissue.

Components of subcutaneous fat

There are two types of fat in the body of a living being - white and brown. White adipose tissue is inherent in humans. If you look at a piece of it under a microscope, you can see a clear division into lobules, connective tissue bridges between the lobules. Also inside the subcutaneous fat layer are blood vessels and nerve fibers.

The main structural component of adipose tissue is the adipocyte cell. Adipocytes have an elongated or round shape and contain lipids, water (30%) and proteins (from 3 to 6%).

This is one of the simplest and most popular methods for determining the percentage of body fat, which is practiced throughout the world. This measurement method is called caliperometry. The method is quite simple - you need to measure the thickness of the skin folds in certain places on the body using calipera- a special device. Then, using the obtained values, using special formulas, you can easily determine the total fat content in the body.

Caliper is a special device for measuring the thickness of the skin fold.

This method is based on the fact that part of the available fat in a person is subcutaneous fat. And, as a rule, knowing how much subcutaneous fat is in the body, you can easily calculate the rest of the internal fat. If the measurements are made correctly, in the right places, then the calculation error is no more than 4-5%.

How to take measurements:

In order to get the most accurate result, you need to take measurements in four places.

1. We measure the thickness of the fat fold on the shoulder in the triceps area. Look at the picture. It is very important that the measurement site is equidistant from elbow joint and shoulder joint.

2. We make measurements on the biceps, i.e. on the opposite side of the arm from the previous measurement.

3. We make a measurement on the shoulder blade. Or rather, we make a pinch just below any of the shoulder blades. Here the skin should be pinched at an angle of 45 degrees to the vertical so that the skin fold is directed along the line connecting the cervical vertebrae and sides. Naturally, for such a measurement, you will need an assistant.

4. We measure the fat fold at the waist at the level of the navel, where there is most fat.

We summarize the results and find out the percentage of subcutaneous fat in the table below.

What percentage of adipose tissue is normal?

Measurement is preferably carried out on the right half of the body.

Do not take measurements in places with damage to the skin.

Take measurements on dry and clean skin.

After physical activity or sauna, the thickness of the skin fold increases due to the accumulation of fluids under the skin. This will inevitably lead to incorrect measurement results. It is very important to capture the folds correctly, otherwise, by capturing the same fold several times, you can get several different values.

But this method, of course, has its "cons".

Firstly In order for the measurement accuracy to be higher, measurements should be carried out by an experienced specialist. This is especially true in cases where it is quite difficult to measure the thickness of the fold due to excessively dense tissues or thick skin, or in people with very much excess body weight or muscle mass.

Secondly, a rather big minus of this method is the inability to test yourself on your own, because. it is almost impossible to check the thickness of the skin fold under the scapula without the help of another person. There is a "simplified" method for measuring the percentage of body fat using a caliper, in which the results are calculated only from the results of one measurement on the abdomen. But the results of such measurements will have a very high error (up to 15%). Therefore, there is no sense in such measurements.