Isaac Jeremy, Walker Lee, Ali Stephen R, Whitaker Iain S
Wish Skin Clinic, Port Talbot, United Kingdom.
B City Clinic, Liverpool, United Kingdom.
JPRAS Open. 2024 Nov 6;43:92-104. doi: 10.1016/j.jpra.2024.10.019. eCollection 2025 Mar.
Understanding the vascular anatomy of the face is crucial for ensuring safe clinical practices, especially as aesthetic procedures involving hyaluronic acid fillers are gaining popularity. Although vascular complications from these procedures are rare, there has been a documented increase in adverse events linked to venous and arterial occlusions. This review addresses the knowledge gap regarding the facial venous system compared to the well-documented facial artery system, emphasising the importance of thorough anatomical knowledge to mitigate risks during injectable cosmetic procedures. The complex and variable anatomy of the facial veins, including connections to the intracerebral venous system, allows for the retrograde spread of infections and fillers, with key tributaries such as the angular and infraorbital veins facilitating communication with the cavernous sinus. Notably, the absence of valves in certain venous regions can lead to retrograde filler flow, exacerbating complications. This illustrated review provides an analysis of the facial venous anatomy, focusing on the distribution and depth of venous structures, and aims to equip practitioners with insights that can help reduce the incidence of vascular complications associated with cosmetic procedures.
了解面部血管解剖结构对于确保安全的临床操作至关重要，尤其是在涉及透明质酸填充剂的美容手术日益普及的情况下。尽管这些手术引起的血管并发症很少见，但与静脉和动脉阻塞相关的不良事件已有记录增加。与记录详尽的面部动脉系统相比，本综述探讨了有关面部静脉系统的知识空白，强调了全面解剖学知识对于降低注射美容手术风险的重要性。面部静脉复杂多变的解剖结构，包括与脑内静脉系统的连接，使得感染和填充剂能够逆行扩散，角静脉和眶下静脉等主要支流促进了与海绵窦的连通。值得注意的是，某些静脉区域没有瓣膜会导致填充剂逆行流动，加剧并发症。本图文并茂的综述分析了面部静脉解剖结构，重点关注静脉结构的分布和深度，旨在为从业者提供有助于降低与美容手术相关血管并发症发生率的见解。
