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New Anatomical Insights on the Course and Branching Patterns of the Facial Artery: Clinical Implications of Injectable Treatments to the Nasolabial Fold and Nasojugal Groove

Yang, Hun-Mu D.D.S., Ph.D.; Lee, Jae-Gi Ph.D.; Hu, Kyung-Seok D.D.S., Ph.D.; Gil, Young-Chun Ph.D.; Choi, You-Jin B.S.D.H.; Lee, Hong-Ki M.D., Ph.D.; Kim, Hee-Jin D.D.S., Ph.D.

Plastic & Reconstructive Surgery: May 2014 - Volume 133 - Issue 5 - p 1077–1082
doi: 10.1097/PRS.0000000000000099
Cosmetic: Original Articles
Discussion

Background: Improper manipulation of injectable treatments to the face can result in disastrous vascular complications. The aim of the present study was to elucidate the detoured course of the facial artery and to provide detailed metric data regarding facial artery location with a view to helping physicians avoid iatrogenic vascular accidents during injectable treatments.

Methods: Sixty specimens from 35 embalmed cadavers (24 male and 11 female cadavers; mean age, 70.0 years) and one fresh male cadaver (age, 62 years) were used for this study.

Results: In 56 cases (93.3 percent), the branches of the facial artery were observed at the vicinity of the nasolabial fold. The facial artery was located 3.2 ± 4.5 mm (mean ± SD) lateral to the ala of the nose and 13.5 ± 5.4 mm lateral to the oral commissure. It crossed the nasolabial fold in 33.9 percent of cases, and ascended within 5 mm of the nasolabial fold in 42.9 percent. The facial artery and detoured branches were found in 18 cases (30.0 percent). In the cases with detoured branches, the facial artery turned medially over the infraorbital area at 39.2 ± 5.8 mm lateral to the facial midsagittal line and 35.2 ± 8.2 mm inferior to the plane connecting the medial epicanthi of both sides. The nasojugal portion of the detoured branch traveled along the inferior border of the orbicularis oculi and then ascended toward the forehead, forming the angular artery.

Conclusion: This detailed vascular anatomy of the facial artery will promote safe clinical manipulations during injectable treatments to the nasolabial fold and nasojugal groove.

Cheonan and Seoul, Republic of Korea

From the Department of Anatomy, College of Medicine, Dankook University; the Department of Dental Hygiene, School of Health and Medicine, Namseoul University; the Division of Anatomy and Developmental Biology, Department of Oral Biology, Yonsei University College of Dentistry; the Department of Anatomy, School of Medicine, Konkuk University; and the Image Plastic and Aesthetic Surgery Clinic.

Received for publication September 28, 2013; accepted November 25, 2013.

Disclosure: None of the authors has received any financial support for this study.

Hee-Jin Kim, D.D.S., Ph.D., Department of Oral Biology, Room 601, Yonsei University College of Dentistry, 50 Yonseiro, Seodaemun-gu, Seoul 120-752, Republic of Korea, hjk776@yuhs.ac

©2014American Society of Plastic Surgeons