Three-Dimensional Computed Tomography of the Detoured Facial Artery: Variations and Implications for Nasojugal Groove Correction

BACKGROUND When performing filler injection procedures to the nasojugal groove, there is the risk of iatrogenic damage to the detoured facial artery. OBJECTIVE To determine the 3-dimensional location of the detoured facial artery. MATERIALS AND METHODS The branches of the facial arteries from 118 cadaveric hemifaces were scanned using computed tomography and reconstructed using the Mimics software program. RESULTS Detoured facial arteries were found in 47 of the 118 hemifaces (39.8%). Two main arterial patterns were identified: in Type I (29 of 47 cases), there were both detoured and nasolabial trunks where the facial artery originated, whereas in Type II (18 of 47 cases), there was only a detoured trunk. The detoured trunk originated 32.0 +/- 5.3 mm from the midsagittal line, 5.0 +/- 2.8 mm from the occlusion plane, and 5.9 +/- 3.5 mm below the skin layer; the inflection of the detoured trunk was located 30.0 +/- 5.6 mm laterally, 26.2 +/- 4.4 mm superiorly, and 5.7 +/- 2.6 mm deep. The meeting point with the inferior orbital rim plane was located 17.1 +/- 3.4 mm laterally, 43.4 +/- 3.1 mm superiorly, and 2.8 +/- 1.7 mm deep. CONCLUSION The 3-dimensional location of the detoured facial artery as reported here will help clinicians to avoid iatrogenic damage when they are performing filler injection procedures.