Camper’s Fascia

Camper’s fascia is the outermost layer of superficial fascia found in the anterior abdominal wall. Composed primarily of adipose tissue, it lies just beneath the dermis and plays an important role in cushioning, insulation, and serving as a protective layer over the muscular wall. Though commonly referred to as a singular structure, its characteristics and thickness can vary significantly depending on location, age, sex, and body fat distribution. While it has limited mechanical function, its clinical importance becomes evident in surgical procedures and trauma involving the abdominal wall.

Structure

Camper’s fascia is part of the superficial fascia system of the anterior abdominal wall. It is a fatty connective tissue layer that overlying Scarpa’s fascia in the lower abdomen.

Composition

• Primarily composed of loose connective tissue and fat lobules
• Contains blood vessels, lymphatics, and cutaneous nerves
• Interspersed with fibrous septa that anchor it to the overlying dermis and underlying Scarpa’s fascia

Thickness

The thickness of Camper’s fascia varies widely:

• Thicker in: Obese individuals and in the lower abdominal wall
• Thinner in: Infants, athletic individuals, and the upper abdomen

Location and Relationships

Camper’s fascia is located immediately beneath the skin and superficial to Scarpa’s fascia in the lower portion of the abdominal wall.

Layer	Relative Position to Camper’s Fascia
Skin	Superficial
Scarpa’s Fascia	Deep (in the lower abdomen)
Abdominal Muscles	Deep to both Camper’s and Scarpa’s fascia

In the upper abdomen, Camper’s fascia merges with deeper layers and is not distinctly separable from Scarpa’s fascia.

Regional Continuations

In certain body regions, Camper’s fascia continues into other anatomical structures, sometimes changing in consistency:

• Thigh: Fuses with fascia lata just below the inguinal ligament
• Perineum: Continues as superficial perineal fat, distinct from Colles’ fascia
• Penis and scrotum (male): Becomes part of the superficial penile fascia; loses fat and merges into Dartos fascia
• Labia majora (female): Continues as a fat-containing superficial layer

These continuities are important in understanding the pathways of fluid spread in trauma or surgical complications.

Function

While not mechanically active like muscle or dense fascia, Camper’s fascia has several passive and physiological functions:

• Cushioning: Protects underlying muscles and organs from mechanical trauma
• Insulation: Helps conserve body heat due to its adipose content
• Fat storage: Stores energy in the form of subcutaneous fat
• Pathway for vessels and nerves: Houses superficial vessels and cutaneous nerves that travel to the skin

Blood Supply and Innervation

The vascular and nerve supply of Camper’s fascia comes from segmental sources that also supply the overlying skin and underlying muscle:

Arterial Supply

• Superficial epigastric artery
• Superficial circumflex iliac artery
• Branches of lower intercostal and lumbar arteries

Venous Drainage

• Superficial epigastric vein
• Thoracoepigastric vein (forms an anastomosis between femoral and axillary veins)

Nerve Supply

• Cutaneous branches of T7–T12 thoracoabdominal nerves
• Iliohypogastric and ilioinguinal nerves (L1)

Clinical Significance

• Surgical relevance: Camper’s fascia is the first significant layer encountered in abdominal wall incisions and must be retracted or divided during surgical exposure.
• Liposuction: This layer is targeted during cosmetic liposuction procedures as it holds most of the abdominal subcutaneous fat.
• Hernias: In some cases of hernia, superficial fascia may become stretched or thinned, affecting closure strength and surgical outcomes.
• Trauma and fluid spread: While not as restrictive as Scarpa’s fascia, Camper’s fascia can still guide the spread of hematomas or infections depending on its attachments and surrounding structures.

Embryology

Camper’s fascia develops from the mesenchyme of the somatic layer of the lateral plate mesoderm. It differentiates alongside the dermis and skin appendages and is influenced by both genetic factors and mechanical stress. Its adipose content expands postnatally and increases significantly under the influence of hormonal and dietary factors.

Differences Between Camper’s and Scarpa’s Fascia

Feature	Camper’s Fascia	Scarpa’s Fascia
Composition	Fatty connective tissue	Fibrous, membranous connective tissue
Thickness	Variable, depends on body fat	Thin but more defined in lower abdomen
Continuations	Labia majora, penis, scrotum	Colles’ fascia, Dartos fascia
Surgical relevance	Relevant for incisions and fat removal	Important for closure and fluid containment
Layer position	Superficial	Deep to Camper’s fascia