Glabellar frown lines as a reliable landmark for the supratrochlear artery

Preservation of the supratrochlear vascular pedicle (SVP) during use of the paramedian forehead flap can be accomplished by the aid of Doppler imaging; however, a reliable surface landmark may be invaluable in cases where Doppler examination fails. Our observations showed that the most prominent glabellar frown lines (GFLs) are very close to the SVP; however, the actual relationship of these structures remains unclear.

The relationship between GFLs and the SVP was investigated in 19 volunteers by the aid of Doppler imaging and in 8 cadaver heads by dissection. The distance between the GFLs and the SVP was measured.

The study took place at an academic tertiary-care facility.

The SVP was located just at the GFLs in almost 50% of the cases and an average of 3.2 mm lateral to GFLs in the remaining cases.

GFLs may serve as reliable surface landmarks in the use of the paramedian forehead flap where Doppler imaging was not helpful.