Arterial anatomy of the face: an analysis of vascular territories and perforating cutaneous vessels.

The cutaneous arterial circulation of the face and scalp was investigated by using multiple anatomic techniques in fresh cadaver specimens. Selective ink injections, dissection and measurement of latex-hardened perforators, and radiographic examination of transverse sections of barium-injected specimens defined 11 vascular territories of the face and scalp. Three distinct patterns of arterial vascularization were observed: (1) small, densely populated musculocutaneous perforating arteries supply the anterior face (facial, infraorbital arteries), (2) large, sparsely populated fasciocutaneous perforators that occur in predictable locations supply the lateral region of the face (branches of the transverse facial, submental, and zygomatico-orbital arteries), and (3) small, densely populated fasciocutaneous perforators supply the scalp (occipital, superficial temporal, and posterior auricular arteries). The locations of the perforation sites of the transverse facial, zygomatico-orbital, supratrochlear, supraorbital, and superficial temporal arteries may be predicted statistically within 2-cm limits with 95 percent certainty for individuals in the general population. The results of this study provide the anatomic framework to potentially revise or improve current reconstructive or aesthetic procedures on the face based on known arteries.