Anatomical study of the blood supply to the skin in rhytidectomy.

This study was undertaken to evaluate the blood supply to the facelift flap by identifying the perforating arteries in the anterior facial region, which is preserved during the undermining of the flap. We have called this medial zone the pedicle area of the flap. Eleven pairs of musculocutaneous perforator arteries supplying the facelift flap were identified, all of them emerging from three main arterial trunks: the facial, the superficial temporal, and the ophthalmic arteries. A rich anastomotic network connected all the vessels; however, we were able to group this network into five basic forms including the ipsilateral and contralateral external and internal carotid arteries. We found these anastomotic links to be constant. We propose that this anatomical feature of the face provides for adequate blood supply even when certain regions have been altered by previous dissection, injury, or congenital deformity. This study confirms previous anatomical findings but also adds specific information regarding the blood supply to the facelift flap that will allow this procedure to be carried out with maximum safety and effectiveness.