External carotid artery and the blood supply of the face
- Artery
Quick facts
- Origin
- Bifurcation of the common carotid in the neck, usually at the level of the upper edge of the thyroid cartilage.
- Terminal branches
- Maxillary artery and superficial temporal artery, within the parotid gland.
- Branches to the face
- Facial, superficial temporal and maxillary are the main ones for the skin and muscles of the face.
- Communications
- With branches of the internal carotid, via the ophthalmic artery, around the eyes, nose and forehead.
- Relevance in facial harmonization
- Explains the arterial map of the face and the path a product can take to the eye's circulation.
The external carotid artery is the artery that carries blood to almost the entire face, the scalp and the neck. It arises from the bifurcation of the common carotid, usually at the level of the upper edge of the thyroid cartilage, runs up the neck and ends inside the parotid gland, dividing into the maxillary artery and the superficial temporal artery. The other half of the system, the internal carotid, supplies the brain and the eye. In facial harmonization, the central point is that the two communicate in the face.
Which branches supply the face?
| Branch | Main territory | Point of concern in facial harmonization |
|---|---|---|
| Facial artery | Lips, nasolabial fold, nasal ala, inner corner of the eye | Origin of the labial arteries and the angular artery |
| Superficial temporal artery | Temple, lateral forehead, scalp | Frontal branch in the forehead; origin of the transverse facial artery and the middle temporal artery |
| Maxillary artery | Deep structures, maxilla, mandible, muscles of mastication | Origin of the infraorbital, mental and deep temporal arteries |
| Lingual artery | Tongue and floor of the mouth | Little relation to aesthetic procedures |
| Occipital and posterior auricular arteries | Nape, posterior scalp, ear | Little relation to facial harmonization |
The other branches, superior thyroid and ascending pharyngeal, supply the neck and pharynx. The branching pattern varies between people, including the order of origin.
How does the external carotid connect to the internal carotid?
The ophthalmic artery, a branch of the internal carotid, leaves the orbit in branches that reach the skin: supratrochlear, supraorbital and dorsal nasal. These branches communicate with the angular (from the facial), with the superficial temporal and with the infraorbital (from the maxillary). The communications are at the glabella, the root and dorsum of the nose, the forehead and around the eyes.
Why does it matter in facial harmonization?
- Risk map: knowing the branch for each region helps explain why the vascular danger zones cluster in the center of the face and the temple.
- Vascular occlusion: vascular occlusion can occur in the territory of the branch itself, with a risk of skin necrosis.
- Visual complication: product inside a branch of the external carotid, pushed with pressure, can travel through the communications to the ophthalmic artery and the central retinal artery. The topic is covered in visual complication after filler.
How does it show up in the assessment?
- Vascular history: surgeries of the face and neck, trauma and previous procedures change the course of the vessels.
- Pulse: in some regions, such as in front of the ear and along the jaw edge, the pulse of branches of the external carotid can be felt.
- Planning: knowing which branch supplies each region helps explain the risks to the patient concretely, in the informed consent.
Also called: external carotid, arteria carotis externa, ECA.
Frequently asked questions
What are the branches of the external carotid artery?
Classically there are eight: superior thyroid, ascending pharyngeal, lingual, facial, occipital, posterior auricular and the two terminal ones, maxillary and superficial temporal. For the face, the most important are the facial, the superficial temporal and the maxillary.
Why can facial filler affect vision if the eye is supplied by the internal carotid?
Because branches of the external carotid, such as the angular and the superficial temporal, communicate with branches of the ophthalmic artery, which comes from the internal carotid. If the product enters a vessel and is pushed with pressure, it can travel through these communications to the artery of the eye.