Variant Blood Supply of the Superficial Face: A Case Report

Introduction: The facial and transverse facial arteries provide the major arterial supply for the superficial face. The facial artery arises from the external carotid artery, in the carotid triangle of the neck, and crosses the angle of the mandible as it ascends the anterolateral face. Following a distinctive course, it continues by running along the oral commissure where it gives off the superior and inferior labial branches. Continuing its trajectory, the artery ascends along the nasolabial sulcus, providing the lateral nasal branch, and concludes its course by terminating as the angular branch near the medial aspect of the eye. The transverse facial artery, which arises from the superficial temporal artery, has a significant role in lateral face vascularization by supplying blood to the parotid gland, masseter, and integument and terminating near the buccal area.

Case Presentation: During a unilateral dissection of a previously hemisected head of a 78-year-old donor from the UNTHSC Willed Body program, variations of the facial and transverse facial arteries were observed. The superficial and deep structures of the face were subsequently dissected and cleaned to expose arterial origins and terminations. The variant anatomical structures were then noted and photographed. The facial artery arose from the external carotid between the lingual and occipital arteries. After crossing the angle of the mandible, the variant facial artery terminated below the oral fissure, supplying blood to the lower face only. The transverse facial artery arose from the superficial temporal, running deep to the parotid gland extending across the lateral face. It then continued in the typical path of the facial artery, following the nasolabial sulcus supplying the muscles and tissues above the oral fissure. It was observed that this variant transverse artery supplied blood to the superficial face instead of the facial artery. Conclusion: The face, like the rest of the human body, has a variety of documented anatomical variations. The observed anatomical variations of the facial and transverse facial arteries highlight the complexity and diversity regarding the vascular supply of the face. The documentation of such variations serves as vital information in clinical and surgical practice to yield the best patient outcomes during treatment.