The sentinel vein: an important reference point for surgery in the temporal region.

An intimate knowledge of the anatomy of the face is essential to the aesthetic surgeon. It is this knowledge that ultimately improves results and minimizes complications. The major morbidity associated with brow lifts is trauma to the temporal branch of the facial nerve. The general course of this nerve has been well documented, but exact details are still lacking. This anatomic study was designed to further elucidate its path. Dissections were performed on each side of 10 fresh cadaver heads. These dissections revealed a consistent relationship between the temporal branch of the facial nerve and the sentinel vein. The sentinel vein is reliably located and preoperatively easily defines the "zone of caution", enabling the surgeon to operate rapidly and with confidence until the zone is reached, at which time the dissection is slower as the vein is approached. In the patient in whom the sentinel vein is not easily visualized externally, it may be identified through fixed skeletal landmarks.