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The philtrum: anatomical observations from a new perspective.
C Alejandra Garcia de Mitchell1, Joel E Pessa, Mark V Schaverien
1Dallas, Texas From the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
Plastic and Reconstructive Surgery
|December 4, 2008
Summary
The upper lip’s philtrum has distinct vascular compartments defined by ascending philtral arteries and membranes. This anatomical understanding aids in cleft lip repair and understanding lip development.
Area of Science:
- Anatomy
- Vascular Anatomy
- Facial Anatomy
Background:
- Previous upper lip anatomy studies focused on muscles.
- Recent work identified facial superficial fat compartments.
- This study applies compartmentalization to the philtrum for anatomical insight.
Purpose of the Study:
- To evaluate the philtrum using the concept of facial fat compartmentalization.
- To enhance understanding of upper lip anatomy, embryology, and clefting.
- To inform surgical techniques for the upper lip.
Main Methods:
- Gross anatomical dissection of five fresh cadaver heads.
- Vascular system delineation via carotid artery injection with colored paint.
- Subdermal dye injection into the philtral hollow followed by dissection and histology.
Main Results:
- Dye injected into the philtrum did not stain skin or orbicularis muscle.
- Dye remained confined within the philtral columns, bordered by membranes.
- These borders correspond to ascending philtral arteries branching from the superior labial artery.
Conclusions:
- Philtral vascular anatomy is linked to superficial upper lip fat compartmentalization.
- A vascular arcade, including ascending philtral arteries and membranes, separates philtral from lateral lip compartments.
- This anatomy correlates with philtral columns and cleft lip locations, offering insights for surgery and development.
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