Anatomical knowledge of the vascular supply to the upper- and lower-lip vermilion is essential for lip augmentation.
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.
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.
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.
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Al-Hoqail RA, Meguid EM (2008) Anatomic dissection of the arterial supply of the lips: an anatomical and analytical approach. J Craniofac Surg 19:785–794
Lazzeri D, Agostini T, Figus M, Nardi M, Pantaloni M, Lazzeri S (2012) Blindness following cosmetic injections of the face. Plast Reconstr Surg 129:995–1012
Park SW, Woo SJ, Park KH, Huh JW, Jung C, Kwon OK (2012) Iatrogenic retinal artery occlusion caused by cosmetic facial filler injections. Am J Ophthalmol 154:653–662
Garcia de Mitchell CA, Pessa JE, Schaverien MV, Rohrich RJ (2008) The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg 122:1756–1760
Kim SN, Byun DS, Park JH, Han SW, Baik JS, Kim JY (2014) Panophthalmoplegia and vision loss after cosmetic nasal dorsum injection. J Clin Neurosci 21:678–680
Koh KS, Kim HJ, Oh CS, Chung IH (2003) Branching patterns and symmetry of the course of the facial artery in Koreans. Int J Oral Maxillofac Surg 32:414–418
Loukas M, Hullett J, Louis RG Jr, Kapos T, Knight J, Nagy R, Marycz D (2006) A detailed observation of variations of the facial artery, with emphasis on the superior labial artery. Surg Radiol Anat 28:316–324
Magden O, Edizer M, Atabey A, Tayfur V, Ergur I (2004) Cadaveric study of the arterial anatomy of the upper lip. Plast Reconstr Surg 114:355–359
Momoh AO, Kelley BP, Diaz-Garcia RJ, Kulkarni AR, Kozlow JH, Bullocks JM, Lee BT (2013) An alternative mucosal flap for nasal lining: the superior labial artery mucosal flap: an anatomic study. J Craniofac Surg 24:626–628
Nakajima H, Imanishi N, Aiso S (2002) Facial artery in the upper lip and nose: anatomy and a clinical application. Plast Reconstr Surg 109:855–861
Ozturk CN, Li Y, Tung R, Parker L, Piliang MP, Zins JE (2013) Complications following injection of soft-tissue fillers. Aesthet Surg J 33:862–877
Pinar YA, Bilge O, Govsa F (2005) Anatomic study of the blood supply of perioral region. Clin Anat 18:330–339
Miss Yasmina M. E. Sahraoui and Miss Hannah E. Greenwood from the University of Liverpool kindly revised this manuscript.
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Tansatit, T., Apinuntrum, P. & Phetudom, T. A Typical Pattern of the Labial Arteries with Implication for Lip Augmentation with Injectable Fillers. Aesth Plast Surg 38, 1083–1089 (2014). https://doi.org/10.1007/s00266-014-0401-8