The Change of Plane of the Supratrochlear and Supraorbital Arteries in the Forehead – An Ultrasound-Based Investigation

Abstract Background Injecting soft tissue fillers into the deep plane of the forehead carries the risk of injection related visual compromise due to the specific course of the arterial vasculature. Objectives To investigate the 2- and 3-dimensional location of the change of plane of the deep branch of the supratrochlear and supraorbital artery, respectively. Methods A total of 50 patients (11 males and 39 females, mean age: 49.76 (13.8) years, mean body mass index of 22.53 (2.6) kg/m 2) were investigated with ultrasound imaging. The total thickness, and the distance of the arteries from the skin and bone surface were measured using a 15-7 MHz broadband compact linear array transducer. Results The deep branch of the supraorbital artery changed plane from deep to superficial to the frontalis muscle at a mean distance of 13 mm [range: 7.0 – 19.0] in males and at 14 mm [range: 4.0 – 24.0] in females and for the deep branch of the supratrochlear artery at a mean distance of 14 mm in males and females [range: 10.0 – 19.0 in males, 4.0 – 27.0 in females} when measured from the superior orbital rim. Conclusions Based on the ultrasound findings in this study, it seems that the supraperiosteal plane of the upper and lower forehead could be targeted during soft tissue filler injections as the deep branches of both the supraorbital and supratrochlear arteries do not travel within this plane. The superficial plane of the lower forehead, however, should be avoided due to the unpredictability and inconsistent presence of the central and paracentral arteries.

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Relationship Between Vertical Glabellar Lines and the Supratrochlear and Supraorbital Arteries

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa138 ◽

2020 ◽

Vol 40 (12) ◽

pp. 1341-1348 ◽

Cited By ~ 1

Author(s):

Sebastian Cotofana ◽

Michael Alfertshofer ◽

Konstantin Frank ◽

Vince Bertucci ◽

Katie Beleznay ◽

...

Keyword(s):

High Risk ◽

Soft Tissue ◽

Soft Tissues ◽

Skin Surface ◽

Surface Distance ◽

Deep Branch ◽

Superficial Branch ◽

Filler Injections ◽

Soft Tissue Filler ◽

The Mean

Abstract Background Glabellar soft tissue filler injections have been shown to be associated with a high risk of causing injection-related visual compromise. Objectives The aim of this study was to identify the course of the superficial branch of the supratrochlear and of the deep branch of the supraorbital artery in relation to the ipsilateral vertical glabellar line and to test whether an artery is located deep to this line. Methods Forty-one healthy volunteers with a mean age of 26.17 [9.6] years and a mean BMI of 23.09 [2.3] kg/m2 were analyzed. Ultrasound imaging was applied to measure the diameters, distance from skin surface, distance between the midline, distance between vertical glabella lines, and the cutaneous projection of the supratrochlear/supraorbital arteries at rest and upon frowning. Results The mean distance between the superficial branch of the supratrochlear artery and the ipsilateral vertical glabellar line was 10.59 [4.0] mm in males and 8.21 [4.0] mm in females, whereas it was 22.38 [5.5] mm for the supraorbital artery in males and 20.73 [5.6] mm in females. Upon frowning, a medial shift in supratrochlear arterial position of 1.63 mm in males and 1.84 mm in females and of 3.9 mm in supraorbital arterial position for both genders was observed. The mean depth of the supratrochlear artery was 3.34 [0.6] mm at rest, whereas the depth of the supraorbital artery was 3.54 [0.8] mm. Conclusions The hypothesis that injecting soft tissue fillers next to the vertical glabellar line is safe because the supratrochlear artery courses deep to the crease should be rejected. Additionally, the glabella and the supraorbital region should be considered as an area of mobile, rather than static, soft tissues.

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Accuracy of ultrasonography in detecting radiolucent soft-tissue foreign bodies

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1734408 ◽

2014 ◽

Vol 24 (02) ◽

pp. 196-200

Author(s):

Morteza Tahmasebi ◽

Hamdollah Zareizadeh ◽

Azim Motamedfar

Keyword(s):

Foreign Body ◽

Soft Tissue ◽

High Frequency ◽

Foreign Bodies ◽

Linear Array ◽

Foreign Body Removal ◽

Retained Foreign Body ◽

Array Transducer ◽

Highly Sensitive ◽

Objective Detection

Abstract Background and Objective: Detection of radiolucent soft-tissue foreign bodies is a challenging problem, which is especially further complicated when retained foreign body is highly suggested by clinicians but radiography is negative. So, blind exploration is sometimes hazardous for patients. The purpose of this study was to determine the accuracy of ultrasonography (USG) in detecting radiolucent soft-tissue foreign bodies in the extremities. Materials and Methods: From November 2011 to January 2012, patients with clinically suspected radiolucent soft-tissue foreign body and negative radiography were evaluated by USG with a 12-MHz linear array transducer. The patients with positive clinical and USG examination were included in our study and underwent exploration or USG removal. Results: Fifty-one patients underwent foreign body removal under ultrasonography-guided or surgical exploration and 47 patients had foreign body (31, 12, 3, and 1 case had thorn, wood, glass, and plastic, respectively). Ultrasound was positive in 50 patients. USG falsely predicted the presence of foreign body in four cases and was falsely negative in one of the cases. Accuracy, sensitivity, and positive predictive value were determined as 90.2%, 97.9%, and 92%, respectively. Conclusions: The real-time high-frequency USG is a highly sensitive and accurate tool for detecting and removing radiolucent foreign bodies which are difficult to be visualized by routine radiography.

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Quantitative Analysis of the Lifting Effect of Facial Soft-Tissue Filler Injections

Plastic & Reconstructive Surgery ◽

10.1097/prs.0000000000007857 ◽

2021 ◽

Vol 147 (5) ◽

pp. 765e-776e

Author(s):

Rami Haidar ◽

David L. Freytag, M.D. ◽

Konstantin Frank ◽

Christina Rudolph ◽

Hassan Hamade, B.Sc. ◽

...

Keyword(s):

Quantitative Analysis ◽

Soft Tissue ◽

Facial Soft Tissue ◽

Filler Injections ◽

Soft Tissue Filler

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Anatomy of the Superior and Inferior Labial Arteries Revised: An Ultrasound Investigation and Implication for Lip Volumization

Aesthetic Surgery Journal ◽

10.1093/asj/sjaa137 ◽

2020 ◽

Vol 40 (12) ◽

pp. 1327-1335 ◽

Cited By ~ 1

Author(s):

Sebastian Cotofana ◽

Michael Alfertshofer ◽

Thilo L Schenck ◽

Vince Bertucci ◽

Katie Beleznay ◽

...

Keyword(s):

Nonverbal Communication ◽

Relevant Information ◽

Central Position ◽

Upper Lip ◽

Lower Lip ◽

3 Dimensional ◽

The Face ◽

Filler Injections ◽

Soft Tissue Filler ◽

Ultrasound Investigation

Abstract Background Lips are considered a key element of facial attractiveness due to their central position in the face and their elemental role in verbal and nonverbal communication. Objectives The authors sought to provide clinically relevant information on the 3-dimensional pathway of the superior and inferior labial arteries within the lips to increase safety during labial soft tissue filler injections. Methods The study enrolled 41 healthy volunteers with a mean age of 26.17 ± 9.6 years and a mean body mass index of 23.09 ± 2.3 kg/m2. Ultrasound imaging was performed at 6 different locations. The position of the labial arteries within the lips, depth of the arteries, cranio-caudal location of each artery in relation to the vermilion border, and diameter of the superior/inferior labial arteries were recorded. Results The most frequent location of both the superior and inferior labial arteries was the submucosal plane (58.5%) followed by intramuscular (36.2%) and subcutaneous (5.3%) planes. The depth of the superior labial artery in the upper lip was 5.6 ± 0.13 mm, whereas the depth of the inferior labial artery in the lower lip was 5.2 ± 0.14 mm. Both arteries were more frequently located within the red lip: upper lip (83% vs 18.7%) and lower lip (86.2% vs 13.8%). In the midline, the artery coursed within the red lip in all investigated volunteers. Conclusions Clinically, results of this study favor a superficial injection plane for lip volumization procedures. A perpendicular approach to the lip (coming from the cutaneous lip) might increase safety because the artery is located most frequently within the red lip.

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