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Our observations show that the extracellular fibrillar world— complex and all-encompassing—is of huge importance. It surrounds the cell and helps to provide and maintain shape and form, but it can only really be appreciated and fully understood in the living state. Architectural Continuity: Fibrillar Intertwining and Microvolumes After cutting through the skin, if you apply light traction upward with small hooks on either side of the incision, structural elements that are initially stacked and piled up on each other will gradually unfold (Image 6) These elements are flattened, but create volume and participate in the creation of shape and form by their superposition on one another. The common assumption that the cells under the skin are arranged in a regular fashion is false. The observation of living structures at magnifications between 10x and 60x reveals a mesh, a woven network, based on the repetition of a polyhedral unit that I have named the microvacuole. The microvacuole is the volume created in the space between the intersections of fibrils. The shape of the microvacuole is polyhedral—completely irregular, yet simple (Image 7). Each microvacuole has its own shape and form; no two are exactly the same. The fibrils run in all directions and, surprisingly, show no pre-established pattern; their arrangement has no apparent logic. They interconnect and interact with each other. The fibrils are a few microns in diameter, with extremely variable lengths and irregular thicknesses, giving a disordered and chaotic appearance—a latticework of stems, branches, stalks, and tendrils. Fibrillar Continuity: Cells Are Not Found Everywhere Undeniably, the recognition of the cell as the basic morphological unit and the understanding of its role in protein production were crucial scientific discoveries. Shape is determined by the grouping together of cells, be they adipocytes, myoblasts, or osteocytes. The liver, thyroid gland, and bone are all examples of dense cellular structures, each with its own specific function. However, the cellular elements that compose them, while certainly essential, are not entirely responsible for their form. Sometimes, cells are too scattered to influence the shape of anatomical structures (Image 5). The cell is sensitive to external conditions and needs some kind of architectural support to live and function. It does not exist in isolation. The study of the cell has monopolized scientific attention and mobilized vast resources, but the extracellular world is still largely unexplored. It is, for all intents and purposes, a scientific desert. If we study only cells through the lens of a microscope, we are at risk of forgetting what surrounds them. Whereas areas of the body may be completely absent of cells, the same cannot be said of the fibrillar extracellular matter. For tissue of such abundance, it is surprising that diagrams in most anatomy and histology textbooks represent it as simply a few lines of collagen or elastin fibers between the mast cells and fibroblasts. Why was it illustrated in such a simplistic way? If it is so simple, why are there several terms to describe it, such as connective tissue, extracellular matrix, ground substance, and interstitial spaces? Cells are present here ( Image 5, 100X), but are too scattered to have influence on shape or form. In Image 6 (20x), you can see the fibers unfold as upward traction is applied. Image 7 (130x) shows the microvacuole—an intersection of fibrils that form a polyhedral unit of volume. The appearance of bubbles after a surgical incision ( Image 8, 5x) is created by the volume in the microvacuoles. When traction is applied to tissue with microbubbles, it puts the microbubbles under tension ( Image 9, 2x). 5 6 7 8 9