Lower Nose Arterial Plexus and Implications for Safe Filler Injections.

Area of Science:

• Anatomy
• Vascular Anatomy
• Facial Anatomy

Background:

• The lower nose possesses a rich arterial supply.
• Despite this, nasal tip necrosis is a known complication of filler injections.
• The precise arterial anatomy of the lower nose requires further elucidation.

Purpose of the Study:

• To investigate the intricate arterial vascularization of the lower nose.
• To identify anatomical variations that may predispose to complications like necrosis.
• To provide anatomical data to enhance the safety of aesthetic procedures.

Main Methods:

• Cadaveric dissection of 40 specimens.
• Application of translucent modified Sihler staining technique.
• Detailed analysis of the arterial patterns in the lower nasal region.

Main Results:

• Identification of a figure-of-eight arterial ring system in the lower nose.
• The upper ring (nasal arterial circle) involves lateral nasal and subalar arteries.
• A more significant lower ring (arterial plexus of the upper lip) receives contributions from facial and superior labial arteries, a previously unreported finding.

Conclusions:

• The complex arterial anatomy of the lower nose, particularly the lower arterial ring, is critical for understanding filler-related risks.
• Awareness of this vascular pattern is essential for aesthetic physicians performing nasal and perioral injections.
• This knowledge aids in implementing safer injection techniques to prevent complications such as necrosis.