External and internal diameters of the facial artery relevant to intravascular filler injection

Background: Vision loss and skin necrosis caused by an accidental intra-arterial embolism or vascular compression are rare but devastating complications when injecting filler materials into the face. Accurate knowledge of the vascular anatomy of the anterior face is crucial for performing safe cosmetic procedures. Methods: Seventy-two facial arteries were harvested from 41 formalin-embalmed cadavers. After removing connective tissues attached to the arterial wall under stereomicroscope observation, the external and internal diameters and wall thicknesses of the facial artery and its branches were measured at various levels along where the arterial courses on the anterior face. Results: The diameter and thickness of the facial artery exhibited significant interregional differences. The external and internal diameters of the facial artery were 1.9±0.4 and 1.2±0.3 mm (mean±SD), respectively, at the inferior border of the mandible, 1.7±0.3 and 1.2±0.3 mm in the vicinity of the inferior labial artery, 1.5±0.3 and 1.0±0.3 mm at the mouth corner, 1.4±0.3 and 0.9±0.2 mm in the vicinity of the superior labial artery, and 1.1±0.2 and 0.7±0.2 mm in the vicinity of the lateral nasal artery. The external and internal diameters at the proximal parts of the inferior labial artery, superior labial artery, and lateral nasal artery were 1.0±0.3 and 0.6±0.2 mm, 0.9±0.3 and 0.6±0.2 mm, and 0.8±0.2 and 0.5±0.2 mm, respectively. Conclusions: Morphometric examinations of the facial artery under stereomicroscope observation as performed in the present study are expected to be more accurate than direct measurements made during cadaveric dissection or conventional histological evaluations. Financial disclosures: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2015R1D1A1A01057983). Ethics: This study conformed to the World Medical Association Declaration of Helsinki (June 1964) and subsequent amendments. Conflict of interest statement: The authors have no conflicts of interest to report Correspondence to: Wu-Chul Song, MD, PhD, Department of Anatomy, Konkuk University School of Medicine, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Republic of Korea, Telephone: +82 2 2030 7819, Fax: +82 2 2030 7845, E-mail: anatomy@konkuk.ac.kr ©2019American Society of Plastic Surgeons

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