Tanvaa Tansatit1, Prawit Apinuntrum, Thavorn Phetudom. 1. Department of Anatomy, Faculty of Medicine, The Chula Soft Cadaver Surgical Training Center, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan, Bangkok, 10330, Thailand.
Abstract
BACKGROUND: Anatomical knowledge of the vascular supply to the upper- and lower-lip vermilion is essential for lip augmentation. METHODS: The soft tissues of the whole face, including arterial latex injection, were peeled off as a facial flap and turned down for dissection. The mucosal flap was elevated away from the orbicularis oris muscle and the lower facial musculature. The superior and inferior labial arteries were traced from the facial artery along the course of the vermilion. RESULTS: The facial artery branched into the superior labial artery just above the labial commissure. This artery ran 4.5 mm deep along the upper lip between the oral mucosa and the orbicularis oris muscle just above the vermilion-mucosa junction to anastomose with the opposing artery. The inferior labial artery originated as a common trunk along with the labiomental artery once the facial artery entered the oral vestibule deep to the platysma muscle. The main arterial trunk coursed along the alveolar border within the plane between the orbicularis oris muscle and the lip depressors. From the arterial trunk emanated the inferior labial artery, which accompanied the mental nerve to the lower lip. CONCLUSION: The vermilion borders of the upper and lower lips are safe for superficial filler injection. All areas of the lower lip are safe because of the minute size of the ascending arteries. To achieve a full upper lip, filler should be injected into the middle body of the lip, thereby avoiding deep injection between the muscle layer and the mucosa, minimizing the risk of injury to the anastomotic arch of the superior labial arteries. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
BACKGROUND: Anatomical knowledge of the vascular supply to the upper- and lower-lip vermilion is essential for lip augmentation. METHODS: The soft tissues of the whole face, including arterial latex injection, were peeled off as a facial flap and turned down for dissection. The mucosal flap was elevated away from the orbicularis oris muscle and the lower facial musculature. The superior and inferior labial arteries were traced from the facial artery along the course of the vermilion. RESULTS: The facial artery branched into the superior labial artery just above the labial commissure. This artery ran 4.5 mm deep along the upper lip between the oral mucosa and the orbicularis oris muscle just above the vermilion-mucosa junction to anastomose with the opposing artery. The inferior labial artery originated as a common trunk along with the labiomental artery once the facial artery entered the oral vestibule deep to the platysma muscle. The main arterial trunk coursed along the alveolar border within the plane between the orbicularis oris muscle and the lip depressors. From the arterial trunk emanated the inferior labial artery, which accompanied the mental nerve to the lower lip. CONCLUSION: The vermilion borders of the upper and lower lips are safe for superficial filler injection. All areas of the lower lip are safe because of the minute size of the ascending arteries. To achieve a full upper lip, filler should be injected into the middle body of the lip, thereby avoiding deep injection between the muscle layer and the mucosa, minimizing the risk of injury to the anastomotic arch of the superior labial arteries. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.
Authors: Alexander D Blandford; Catherine J Hwang; Jason Young; Alexander C Barnes; Thomas P Plesec; Julian D Perry Journal: Ophthalmic Plast Reconstr Surg Date: 2018 May/Jun Impact factor: 1.746