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Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
There is some contention as to the predominant artery supplying the procerus muscle, with some anatomists arguing it is supplied by branches of the facial artery tracking superiorly along the lateral aspect of the nasal bone, whereas others suggest that it is supplied by branches of the supraorbital ophthalmic artery, which you should be familiar with from the previous section on the frontalis muscle. The facial artery arises from the external carotid artery (the ophthalmic artery arises from the internal carotid artery) slightly superior to the lingual artery. After branching from the external carotid artery, the facial artery dips medially to the angle of the mandible before curving underneath it and heading superiorly along the mandibular ramus, branching off the superior and inferior labial arteries which supply the top and bottom lips respectively. The facial artery continues to take a tortuous path up the maxillary bone and then parallel to the nasal bone, heading superiorly until it terminates as the angular artery in the corner of the eye.
Anatomy of the head and neck
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
The arterial supply to the lower face is via the facial artery, a branch of the external carotid artery. This artery enters the face by looping across the mandible, almost to the midpoint of the ramus where it can be located by finding the small notch on the margin of the mandibular ramus in which it lies. It passes upwards and medially towards the margin of the mouth where it divides to give rise to superior and inferior labial arteries, supplying the lips. A further branch extends upwards towards the medial aspect of the eye and orbit alongside the nose.
Nasolabial Region
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Berend van der Lei, Jinda Rojanamatin, Marc Nelissen, Henry Delmar, Jianxing Song, Izolda Heydenrych
The facial artery arises from the external carotid artery, after which it travels superoanteriorly from the premasseteric area to the adjacent portion of the nasion. Many studies have found that the facial artery branches to form the inferior and superior labial, inferior alar, lateral nasal, and angular arteries. It pursues a tortuous course and presents an extremely intricate and varied branching pattern (Figure 6.11).
Complications associated with infraorbital filler injection
Published in Journal of Cosmetic and Laser Therapy, 2020
Shivani Reddy, Tuyet A. Nguyen, Nima Gharavi
Notable vasculature in this region include the infraorbital artery, angular artery, dorsal nasal artery, and zygomaticofacial artery (Figure 1). The infraorbital foramen, from which the infraorbital artery and nerve exit, is typically located medially 1/3 of the distance between the medial and lateral canthi, and on average between 6.3–10.9 mm below the infraorbital rim and is not reported to change significantly with age (6,7). The angular artery, a branch of the facial artery, courses along the medial periorbital area and anastomoses with the dorsal nasal artery here (6). This artery can have variations in location, and in some may be located more superficially in the subcutaneous tissue. The zygomaticofacial artery and nerve arise from a foramen at the lateral orbital rim about 0.5–1.0 cm below the horizontal line at the lateral canthus (8).
Unfavorable outcomes in microsurgery: possibilities for improvement
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Paolo Cariati, Almudena Cabello Serrano, Fernando Monsalve Iglesias, Maria Roman Ramos, Jose Fernandez Solis, Ildefonso Martinez Lara
It is important to emphasize that only 8 of the 65 (12.3%) oncological patients received RT before reconstructive surgery in our series. Specifically, five patients from Group 1 and 3 patients from Group 2 had previously been treated with ablative surgery and postoperative radiotherapy. Hence, the quality and quantity of the vessels was acceptable in most cases. In Group 1, the facial artery was used in 86.7% of cases (n = 46), followed by the cranial thyroid artery (11.3%; n = 6), and external carotid artery (1.8%; n = 1). All arterial anastomoses were end to end. Regarding the veins, the facial vein was the most used followed by the external jugular vein. We tried to use two veins whenever possible. Also, all venous anastomoses were end to end. In Group 2, the facial artery was also the artery most frequently used (77.7%; n = 14) followed by the external carotid artery (22.2%; n = 4). No arterial anastomoses were performed with the cranial thyroid artery in this group. The external carotid artery was used after an intraoperative spasm of the facial artery in two cases and in the salvage surgery of a fibula flap 12 h after primary reconstructive surgery. In only one case was the first choice. The facial vein was the one most commonly used, followed by the external jugular vein. All arterial and venous anastomoses were end-to-end also in this group.
A Unique Method for Total Nasal Defect Reconstruction - Prefabricated Innervated Osteocutaneous Radial Forearm Free Flap
Published in Case Reports in Plastic Surgery and Hand Surgery, 2019
Uros Ahcan, Vojko Didanovic, Ales Porcnik
Five weeks after uneventful postoperative recovery, a 2nd stage was performed. “Neo-nose” was re-raised with a 12 cm long vascular pedicle including a LABCN (Figure 5A). All shaped tissues (nose inner lining and supporting midlayer framework) were viable and with excellent vascular supply. After titanium coated cage was removed, tissues preserved their desired shape and remained appropriately firm (Figure 5B, C). Simultaneously, facial artery, vein and a nasal branch of infraorbital nerve were prepared. After tunnelling pedicle under the cheek, end-to-end anastomoses were performed using interrupted 8–0 sutures for the artery and nerve and running 9–0 sutures for the vein. Bone framework was fixed to the frontal bone and maxilla using titanium micro-plate and screws. In the same stage, tissue expander was removed, pre-expanded paramedical forehead flap harvested, rotated downwards and sutured over the “neo-nose” with interrupted sutures (Figure 6A–F). Small defects on the forehead and forearm were skin grafted. Patient was discharged home as all flaps were well perfused.