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Determining safe entry sites for filler injections on the lateral canthal vertical line: anatomical study of the midface arterial perforators in soft embalmed cadavers

Chalermquan Rungsawang
Chalermquan Rungsawang
, 
Tanvaa Tansatit
Tanvaa Tansatit
, 
Thirawass Phumyoo
Thirawass Phumyoo
, 
Benrita Jit-aree
Benrita Jit-aree
 et 
Sukanya Uruwan
Sukanya Uruwan
   | 31 mars 2017
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Article Category: Brief communication (Original)
Publié en ligne: 31 mars 2017
Pages: 619 - 625
DOI: https://doi.org/10.5372/1905-7415.1006.532
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© 2016 Chalermquan Rungsawang, Tanvaa Tansatit, Thirawass Phumyoo, Benrita Jit-aree, Sukanya Uruwan
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

The incision line was made vertically down the center of the face, and 2 incisions were made perpendicular to this initial incision.
The incision line was made vertically down the center of the face, and 2 incisions were made perpendicular to this initial incision.

Figure 2

Measurement of the distance of the perforator to the standard axis. The X axis as the Frankfort’s horizontal line, the Y axis as the lateral canthal line.
Measurement of the distance of the perforator to the standard axis. The X axis as the Frankfort’s horizontal line, the Y axis as the lateral canthal line.

Figure 3

The 3 types of middle midface perforators according to their main arterial origin. A: Buccal artery perforator. B: Parotid artery perforator, and C: Facial artery perforator branches from facial artery (FA). With written permission from the nearest living relatives for publication of these photographs in this article.
The 3 types of middle midface perforators according to their main arterial origin. A: Buccal artery perforator. B: Parotid artery perforator, and C: Facial artery perforator branches from facial artery (FA). With written permission from the nearest living relatives for publication of these photographs in this article.

Figure 4

Location of the 3 types of perforator arteries. On the upper panels, we show all the middle midface perforators on a standard face (a) 16 specimens, type I or buccal artery perforator, (b) 7 specimens, type II or parotid artery perforator, (c) 5 specimens, type III or facial artery perforator. On the lower panels, we show the mean location of the 3 types: A: buccal artery perforator, B: parotid artery perforator, and C: facial artery perforator within 4 levels (origin of the perforator, oral commissure, lower alar, and upper alar). The X axis is Frankfort’s horizontal line; and the Y axis is the lateral canthal line. With written permission from the model to publish these photographs.
Location of the 3 types of perforator arteries. On the upper panels, we show all the middle midface perforators on a standard face (a) 16 specimens, type I or buccal artery perforator, (b) 7 specimens, type II or parotid artery perforator, (c) 5 specimens, type III or facial artery perforator. On the lower panels, we show the mean location of the 3 types: A: buccal artery perforator, B: parotid artery perforator, and C: facial artery perforator within 4 levels (origin of the perforator, oral commissure, lower alar, and upper alar). The X axis is Frankfort’s horizontal line; and the Y axis is the lateral canthal line. With written permission from the model to publish these photographs.

Anatomical measurements of the middle midface perforators

MeasurementsBuccal artery perforator mean (SD) mmParotid artery perforator mean (SD) mmFacial artery perforator mean (SD) mm
Distance of the perforator at the upper alar crease
X32.6 (6.0)4.2 (10.8)11.2 (10.8)
Y3–16.4 (5.4)–13.9 (3.4)–16.0 (5.3)
Distance of the perforator at the lower alar crease
X21.0 (8.7)7.4 (9.4)8.4 (13.2)
Y2–33.0 (4.5)–27.3 (7.2)–27.4 (2.9)
Distance of the perforator at the oral commissure
X1–4.2 (7.4)-7.3*
Y1–57.8 (5.9)-–52.8*
Distance of the perforator at its origin
X0–2.8 (11.0)21.1 (7.2)7.7 (10.6)
y„-57.1 (9.2)-32.4 (11.5)-54.7 (13.3)
Diameter of the perforator at the origin0.9 (0.2)0.8 (0.3)0.7 (0.1)
Length of the perforator72.3 (18.7)58.6 (13.5)72.0 (12.5)
Depth of the perforator at the origin from the skin4.1 (1.0)4.2 (1.4)4.7 (2.0)
Diameter of the main artery1.1 (0.3)1.1 (0.4)1.3 (0.4)

Origin patterns of the perforators at the middle midface region

Sex/side\TypeI. Buccal arteryII. Parotid arteryIII. Facial artery
n%n%n%
Male96442917
Female750321429
Left750321429
Right96442917
Total1657725518
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