The Depth of the Facial Artery, Meta-analysis

The depth of the facial artery (FA) probably is the most crucial factor while performing aesthetic procedures. The course of FA varies on different levels. The knowledge of exact depth can help physicians to locate the FA more accurately, thereby enhancing the safety of filler injections. This research is the first meta-analysis focused on the quantitative comparison of depth on five different levels of facial artery including angular artery.

Twelve research papers were included in the meta-analysis. The analyses were performed in five distinctive places: (1) on the horizontal level of cheilion, (2) between oral commissure and nasal alae, (3) on the horizontal level of nasal alae, (4) between nasal alae and medial eye canthus and (5) on the horizontal level of medial eye canthus.

A total of 794, 514, 1095, 414 and 450 arteries were analyzed at the following horizontal levels, respectively: at the level of cheilion, between the nasal alae and oral commissure, at the level of nasal alae, between the nasal alae and medial eye canthus and at the level of medial eye canthus. The final results were as follows: 9.72, 95% CI (6.50-12.94) [mm], 10.34, 95% CI (5.24-15.44) [mm], 9.21, 95% CI (7.05-11.38) [mm], 4.68, 95% CI (4.04-5.31) [mm] and 2.38, 95% CI (1.38-3.38) [mm], respectively.

It appears that performing filler injections up to a depth of 4.5 mm, superficially to the facial artery, is considered safe at the level of the oral commissure. The depth between nasal alae and oral commissure varies significantly. A USG exam during the initial consultation prior to any aesthetic procedure might be a reasonable solution in the upper parts of the nasolabial fold.

This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .