Anatomic Dissection of the Arterial Supply of the Lips

Abstract

Previous investigators have not described some of the new anatomic variations or provided quantitative and analytical data of the arterial anatomy of the lips in as much depth as in this study. Dissections of 14 different facial sides of cadavers were done. Through investigating the arterial supply of the upper and lower lips, measurements were performed and statistically analyzed. The main arterial supply of the upper lip was from the superior labial artery (SLA, mean external diameter, 1.8 mm [SD, 0.74 mm]); in addition, the subalar and septal branches contributed to its vascularization. The origin of the SLA was above the labial commissure in 78.6%. The subalar branch was not found but replaced by the alar artery that arose from the infraorbital artery in 1 specimen. The main arterial supply of the lower lip was derived from 3 branches of the facial artery, the inferior labial artery (mean external diameters, 1.4 mm [SD, 0.31 mm]) and the horizontal and vertical labiomental arteries. The inferior labial artery originated mostly below the labial commissure in 42.9% and formed a common trunk with the SLA in 28.6%. The horizontal labiomental artery was present in all, but vertical labiomental artery was absent in 21.4% of specimens. Overall, observed anatomic variations were classified into types I to VIII. Significant relations between the demographic variables and measured parameters were reported including the correlation coefficient among evaluated parameters. In conclusion, this study provides various information that aids in creating new flaps and supports the vascular base for clinical procedures in reconstructive surgery of the lip.

Italian consensus report on the aesthetic use of onabotulinum toxin A

“…Men have a facial muscle mass significantly larger and thicker, characterized by a higher functional activity that anticipates the appearance of wrinkles and makes them deeper. The lower third of the male face, on the other hand, shows fewer signs of aging than its female counterpart, due to the presence of more pilosebaceous annexes, and a more developed vascularization of the same area …”

The facial artery

“…It is observed bilaterally in 36–90% of cases after cadaveric dissection, but only in 17% of cases by CT angiography (Edizer et al, ; Pinar et al, ). As the external diameter of the ILA is <1 mm, resolution by CT angiography could be insufficient to detect every ILA branch (Park et al, ; Crouzet et al, ; Kawai et al, ; Pinar et al, ; Al‐Hoqail and Meguid, ).…”

“…In the second, it branches below the cheilion and ascends along the labiomental crease; this branch is sometimes defined as the horizontal labiomental artery (hLMA) to distinguish it from the ILA. Several vertical branches of the hLMA anastomose with the ILA routing along the first pattern or submental artery (SMA) (Kawai et al ; Al‐Hoqail and Meguid, ), which are defined as the vertical labiomental arteries (vLMA). In addition, an artery deeply proceeding along the labiomental crease toward the muscles or the periosteum of the mentum is known as the horizontal mental branch, sublabial artery, or cortical branch (Park et al ; Edizer et al, ; Loukas et al, ).…”

“…The SLA commonly issues branches ascending vertically toward the nasal septum, known as septal branches, subseptal branches, nasal septal branches, collumellar arteries, alar branches, or ascending branches (Park et al, ; Crouzet et al, ; Nakajima et al, ; Magden et al, ; Pinar et al, ; Al‐Hoqail and Meguid, ; Loukas et al, ; Lee et al, ). The regular term in TA98 is the nasal septal branch (NSbr).…”

Vermilion lower lip cross flap - An anatomic study on 22 fresh cadavers

“…[1314] In Table 2, diameters of inferior labial artery at origin are shown. [71015–17] Earlier only one study has shown an internal diameter diameter of inferior labial artery measured; 0.8 mm (0.2-1.4 mm) in origin. [7] This study showed that inferior labial artery was located in the submucous layer in 77.27% cases and in 13.64% of the specimens this artery was in the superficial muscle layer of the orbicularis oris.…”