From the Division of Clinical Anatomy, Kansas City University.
Surek Plastic Surgery.
Plast Reconstr Surg. 2023 Aug 1;152(2):257e-263e. doi: 10.1097/PRS.0000000000010212. Epub 2023 Jul 27.
Demand for lip filler injection continues to increase. Despite the current literature's acknowledgement of the role both venous and arterial vasculature play in minor and major side effects, research addressing the venous vasculature of the lower one-third of the face is scarce.
A photographic analysis of the venous vasculature of 26 participants was performed using a vein transilluminator to display the venous flow around the perioral region. The data were analyzed for commonalities among participants and then compared with common lip filler injection techniques and locations.
Venous tributaries were identified in all patients, with slight variation in pattern, superior to the upper vermilion border between the nasolabial fold and philtral column on each side of the mouth. Venous tributaries were noted approximately 1 to 1.5 cm lateral to the oral commissures extending inferiorly to the chin and along the labiomental crease. Four areas of venous pooling were deemed significant: a small area approximately 2 mm superior to the Cupid's bow, along the middle tubercle of the upper lip, along the wet-dry line of the lower lip; and centrally along the vermilion border between the lower lip tubercles.
Perioral venous mapping provides a guide for injectors performing lip enhancement procedures in identifying areas at risk for injury because of venous pooling. Avoiding these anatomically vulnerable regions can minimize the potential for inflammation and ecchymosis associated with intravenous injection and prevent dissatisfactory aesthetic results because of lumps, excessive bruising, swelling, or asymmetry.
唇部填充物注射的需求持续增加。尽管目前的文献已经认识到静脉和动脉血管在轻微和严重副作用中所起的作用，但关于面部下三分之一的静脉血管的研究却很少。
使用静脉透照仪对 26 名参与者的静脉血管进行了摄影分析，以显示口周区域的静脉血流。对参与者的共同特征进行了数据分析，然后将其与常见的唇部填充物注射技术和位置进行了比较。
在所有患者中都发现了静脉支流，其模式略有差异，位于上唇红缘上方，在鼻唇沟和唇柱之间的每侧口角。静脉支流位于口角外侧约 1 至 1.5 厘米处，向下延伸至下巴，并沿着唇颏沟。有四个静脉汇流区域被认为是重要的：一个约 2 毫米大小的区域位于丘比特弓上方，在上唇中央结节的中部；在下唇干湿线处；以及下唇唇红缘的中央。
口周静脉图谱为进行唇部增强手术的注射者提供了一个指南，以识别因静脉汇流而容易受伤的区域。避免这些解剖上脆弱的区域可以最大程度地减少与静脉内注射相关的炎症和瘀伤的潜在风险，并防止因肿块、过度瘀伤、肿胀或不对称而导致不满意的美学效果。
