Arteries of the Face and Their Relevance for Minimally Invasive Facial Procedures

An Anatomical Review

Sebastian Cotofana, Nirusha Lachman

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BACKGROUND: The purpose of this article is to provide a comprehensive review based on images and discussion of the current understanding of the arterial supply of the face to facilitate safe minimally invasive antiaging procedures. METHODS: Contrast-enhanced computed tomographic scans of 40 fresh frozen heads from 17 male and 23 female Caucasian body donors with a mean age of 76.9 ± 13.1 years and a mean body mass index of 23.6 ± 5.3 kg/m(2) were retrospectively analyzed and compared to cadaveric dissections performed in more than 400 fresh cephalic specimens. RESULTS: This review presents the current understanding of the facial arteries based on existing literature, direct observation from cadaveric dissection, and the dissection experience of the two authors of the study. It reveals the constant three-dimensional locations of the facial and angular arteries: mandible, modiolus, and medial canthus as compared to their unpredictable course in other facial regions. In addition, the anatomy of the ophthalmic and central retinal arteries is discussed in the context of current treatment strategies in cases of blindness following facial soft-tissue filler injections. CONCLUSIONS: The arterial supply of the face exhibits high variability in branching patterns, course (two-dimensional), and depth (three-dimensional). Because of the lack of predictability of the vascular anatomy, it is impossible to absolutely guarantee safety when performing minimally invasive injectable procedures. Injectors should understand the potential for adverse vascular events, communicate this risk appropriately to patients, and be properly trained and equipped to treat any such complication.

Original languageEnglish (US)
Pages (from-to)416-426
Number of pages11
JournalPlastic and reconstructive surgery
Volume143
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Dissection
Arteries
Blood Vessels
Anatomy
Head
Retinal Artery
Lacrimal Apparatus
Injections
Blindness
Mandible
Body Mass Index
Observation
Tissue Donors
Safety
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Arteries of the Face and Their Relevance for Minimally Invasive Facial Procedures : An Anatomical Review. / Cotofana, Sebastian; Lachman, Nirusha.

In: Plastic and reconstructive surgery, Vol. 143, No. 2, 01.02.2019, p. 416-426.

Research output: Contribution to journalArticle

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