Evaluation of facial artery course variations and depth by Doppler ultrasonography.

Abstract

As deep nasolabial folds (NLF) are associated with facial aging, there is an increasing demand for esthetic correction with filler injections. Understanding the anatomy of the angular artery (AA) and facial artery (FA) around the NLF region is essential for ensuring the safety of dermal filler injections into the NLF. The purpose of this study was to provide detailed vascular anatomical information on the course and depth of AA and FA around NLF using Doppler ultrasound on live cases. FA was observed from the origin level adjacent to the mandible corpus to the end of its terminal branch AA in 168 hemifaces of 84 cases with Doppler ultrasonography. We made a classification of the FA course based on the NLF. The minimum and maximum depths of the FA along its course were measured in 84 cases. The results showed that its course may be highly superficial (2.5mm at the mandibular origin, 3.7mm at the cheilion, 3.7mm at the nasal ala) or it may follow a very deep course near the periosteum (15.0mm at the mandibular origin, 18.7mm at the cheilion, 23.5mm at the nasal ala). FA depth was varied between 5.98mm and 6.62mm at the mandibular origin, between 8.36mm and 9.20mm at the cheilion, between 9.52mm and 10.51mm at the nasal ala at a 95% confidence interval. This study suggests that there is no absolutely safe depth or region for nasolabial fold filler injections.