Pourani Mohammad Reza, Ebrahimzade Mandana, Goudarzi Ehsan, Kassir Martin, Robati Reza, Moravvej Hamideh, Abdollahimajd Fahimeh
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Cosmet Dermatol. 2025 Sep;24(9):e70431. doi: 10.1111/jocd.70431.
The facial artery (FA), as the primary vascular structure of the face, exhibits numerous anatomical variations. Determining its anatomical variation (vascular mapping) by ultrasonography (US)-a non-invasive, low-cost, practical, and bedside-applicable imaging technique-helps achieve safe aesthetic injections, averting complications such as ischemia and necrosis.
This study aimed to evaluate the anatomical characteristics of FA under the guidance of US, including course variations in relation to the nasolabial fold (NLF), depth, and diameter.
This systematic review and meta-analysis used the 2020 update of the PRISMA guidelines. The detailed protocol is registered with PROSPERO. Original studies with extractable numerical data that applied Doppler US in normal adult populations to illustrate FA anatomy were evaluated. The primary two outcomes of the study were (1) the pooled visualization rate of the FA in each of the three anatomical levels and (2) the pooled prevalence of each FA course variation according to the NLF.
A systematic search through the three online databases identified 1087 records, of which 580 underwent title and abstract screening after duplicate removal, and 10 studies were included. The visualization rates at three anatomical facial levels were 100%, 99.9%, and 99.8% of all arteries. FA running medial to the NLF (type A) (46.2%), followed by FA crossing medial to lateral of the NLF (type C) (22.5%), were the most frequent courses of FA in relation to the NLF. In contrast, the FA running lateral to the NLF (type B) (12.0%) was the scarcest variation. The FA became more profound in the skin layers as it ascended in the face from level 1 (6.27 mm) to level 3 (8.04 mm). Moreover, the FA narrowed in diameter from level 1 (2.14 mm) to level 3 (1.46 mm) as it branched out and approached its termination point. Therefore, the total prevalence of angular, lateral nasal, and superior labial artery as the final branch of the FA in our study was 71.8%, 27.9%, and 5.7%, respectively.
According to the results, the US could detect FA in almost all cases at the three levels of the face, including the lower border of the mandible, cheilion, and lateral nasal ala. This systematic review and meta-analysis provided a comprehensive anatomical knowledge of the Doppler-visualized FAs as an exemplary schema of pre-procedural vascular mapping that can help aestheticians prevent intravascular injections, exerting safer performance during cosmetic procedures.
PROSPERO number: CRD42024616195.
面动脉（FA）作为面部主要的血管结构，存在众多解剖变异。通过超声检查（US）——一种无创、低成本、实用且可在床边应用的成像技术——确定其解剖变异（血管造影），有助于实现安全的美容注射，避免缺血和坏死等并发症。
本研究旨在评估超声引导下面动脉的解剖特征，包括与鼻唇沟（NLF）相关的走行变异、深度和直径。
本系统评价和荟萃分析采用2020年更新的PRISMA指南。详细方案已在PROSPERO注册。评估了在正常成年人群中应用多普勒超声以阐明面动脉解剖结构且具有可提取数值数据的原始研究。该研究的两个主要结果为：（1）三个解剖层面中每个层面面动脉的汇总可视化率；（2）根据鼻唇沟划分的每个面动脉走行变异的汇总患病率。
通过三个在线数据库进行的系统检索共识别出1087条记录，其中580条在去除重复项后进行了标题和摘要筛选，纳入了10项研究。面部三个解剖层面的可视化率分别为所有动脉的100%、99.9%和99.8%。与鼻唇沟相关的面动脉走行中，最常见的是走行于鼻唇沟内侧的A型（46.2%），其次是从鼻唇沟内侧向外侧穿过的C型（22.5%）。相比之下，走行于鼻唇沟外侧的B型（12.0%）变异最为少见。面动脉从第1层面（6.27毫米）向上行至面部第3层面（8.04毫米）时，在皮肤层中位置逐渐变深。此外，面动脉在分支并接近其终末点时，直径从第1层面（2.14毫米）变窄至第3层面（1.46毫米）。因此，在本研究中，角动脉、鼻外侧动脉和上唇动脉作为面动脉终末分支的总患病率分别为71.8%、27.9%和5.7%。
根据研究结果，超声几乎可在面部的三个层面（包括下颌下缘、口角和鼻翼外侧）检测到面动脉。本系统评价和荟萃分析提供了关于多普勒可视化面动脉的全面解剖知识，作为术前血管造影的示例模式，可帮助美容师预防血管内注射，在美容手术中实现更安全的操作。
PROSPERO编号：CRD42024616195。
