Glabellar frown lines as a reliable landmark for the supratrochlear artery

OBJECTIVE: Preservation of the supratrochlear vascular pedicle (SVP) during use of the paramedian forehead flap can be accomplished by the aid of Doppler imaging; however, a reliable surface landmark may be invaluable in cases where Doppler examination fails. Our observations showed that the most prominent glabellar frown lines (GFLs) are very close to the SVP; however, the actual relationship of these structures remains unclear. STUDY DESIGN: The relationship between GFLs and the SVP was investigated in 19 volunteers by the aid of Doppler imaging and in 8 cadaver heads by dissection. The distance between the GFLs and the SVP was measured. SETTING: The study took place at an academic tertiary-care facility. RESULTS: The SVP was located just at the GFLs in almost 50% of the cases and an average of 3.2 mm lateral to GFLs in the remaining cases. CONCLUSION: GFLs may serve as reliable surface landmarks in the use of the paramedian forehead flap where Doppler imaging was not helpful.