Anatomical Characterization of Transverse Facial Artery Perforators: A Micro-computed Tomography and Cadaveric Study

Area of Science:

• Anatomy
• Medical Imaging
• Surgical Planning

Background:

• Transverse facial artery (TFA) perforators form the lateral face's subdermal vascular plexus.
• Limited 3D data exists on TFA perforator course, depth, and landmark relationships.

Purpose of the Study:

• To map the 3D topography of TFA perforators and the subdermal vascular plexus.
• Utilize micro-CT, conventional CT, and cadaveric dissection for detailed analysis.

Main Methods:

• Analysis of 48 hemifaces from 24 adult cadavers.
• CT imaging, anatomical dissection, and PTA-stained micro-CT.
• Quantification of perforator locations relative to facial landmarks and measurement of plexus depth.

Main Results:

• TFA perforators identified in 96% of cases, predominantly a single dominant vessel.
• Emergence point located 31.7 mm lateral and 40.3 mm inferior to the lateral canthus at 11.3 mm depth.
• Subdermal plexus (3-5 mm depth) distributed in inferolateral orbital and malar regions after SMAS traversal.

Conclusions:

• 3D anatomical data offers a practical reference for surgical and minimally invasive interventions.
• Precise TFA perforator location and depth aid in optimizing flap design for facelifts and reconstruction.
• Enhanced safety for procedures like filler injections and thread-lifting.