The Arteries of the Central Forehead: Implications for Facial Plastic Surgery

BACKGROUND: The forehead has substantial importance as an aesthetic unit. The central and supraorbital parts of this area are supplied by the supratrochlear (ST) and supraorbital (SO) arteries, as well as the recently defined paracentral (PA) and central arteries. OBJECTIVES: This study aimed to assess the morphometry of the vessels of the forehead in the context of plastic surgery and minimally invasive cosmetic procedures. METHODS: This research included 40 cadavers who were directed for forensic autopsy and subjected to postmortem computed tomography angiography. In total, 75 hemifaces were examined for the course and location of arteries, relative to the bones and surrounding structures. RESULTS: The arteries were observed as follow: ST in 97.3%, SO in 89.3% and PA in 44.0%. The PA can be expected in the 13 mm wide zone starting 2 mm laterally from the midline. The ST should be expected in the 10 mm wide area extended laterally from the tenth millimeter from the midline and the SO should be expected in the slightly wider (11 mm) area extending laterally from the 20th millimeter from the midline. For the proximal main trunks of the ST and SO arteries, we observed no overlap between the zones of occurrence, whereas the zones for the PA and ST main proximal trunks did overlap. No distinctive central artery was observed in the midline region of the forehead, but instead, a network of small vessels in the midline region was visible. CONCLUSION: The ST is the main and most conservative artery of this region, while the PA is the most variable. A unique and detailed anatomical map was created to better understand the vasculature of the forehead area.