Facial Arteries & Veins

The facial artery, a branch of the external carotid, is the major vessel supplying blood to the superficial face.

At the mandible, the facial artery crosses diagonally towards the nose, running a tortuous path at the nasolabial fold, before advancing to the lateral nasal wall in the alar crease and terminating in the angular artery. This runs towards the medial orbital rim.

At the junction between the facial and angular arteries lies the lateral nasal artery, which supplies the 78% of the blood to the nose (nasal tip and ala), and blood to the remaining 22% of the nose via the dorsal nasal artery.

Compression or occlusion of the facial artery in the nasolabial fold or further on at the angular or dorsal nasal artery can lead to alar necrosis or necrosis of the tip of the nose.

The anatomy relative to vascular complications

Facial Arteries and Veins

The facial vein, which runs alongside the facial artery, lies at a distance of around 2-3cm lateral to the ala of the nose and similarly at the level of the oral commissure.

The facial vein also demarcates the medial border of the medial fat pad of the face, which is triangular and often subject to volumisation with fillers.

Compression or occlusion of the facial vein or its tributaries can lead to a dull ache, dusky grey/mottled appearance and progressive ischaemia of the tissues.

The anastomosis (connection) of the dorsal nasal arteries with the ophthalmic arteries occurs at the medial canthus and from here blood can access the central retinal arteries via the ophthalmic arteries .

The ophthalmic artery is a branch of the internal carotid, and in turn supplies its orbital group, consisting of lacrimal, supraorbital, posterior ethmoidal, anterior ethmoidal, internal palpebral, frontal and nasal arteries, and the ocular group, consisting of long ciliary, short ciliary, anterior ciliary, muscular and central retina arteries .

Danger zones for inflatables of the face