Facial vein: course and relationship to the artery
- Vein
Quick facts
- Origin
- Continuation of the angular vein, below the lower edge of the orbit, beside the nose.
- Course
- Runs diagonally down the cheek, in a straighter line than the facial artery, to the lower edge of the mandible.
- Relationship to the artery
- It generally runs lateral and posterior to the facial artery, which is more tortuous.
- Drainage
- In the neck, it joins branches of the retromandibular vein and drains into the internal jugular vein.
- Connections
- With the ophthalmic veins, through the angular vein, and with the pterygoid plexus, through the deep facial vein.
- Relevance in orofacial harmonization (HOF)
- Source of bruising in the midface and a landmark for the boundary between cheek fat compartments.
The facial vein is the main superficial vein of the face. It begins as a continuation of the angular vein, below the lower edge of the orbit, runs diagonally down the cheek in a relatively straight line and crosses the lower edge of the mandible just in front of the masseter muscle. In the neck, it receives branches of the retromandibular vein and drains into the internal jugular vein. In orofacial harmonization (HOF), it matters because it lies in the path of midface and jawline procedures.
What is the course of the facial vein?
| Segment | What to look for |
|---|---|
| Start | Beside the nose, below the edge of the orbit, as a continuation of the angular vein |
| Midface | Runs diagonally, deep to the zygomatic muscles, toward the angle of the jaw |
| Lower cheek | Passes along the anterior edge of the masseter, near the masseteric ligaments |
| Mandible | Crosses the lower edge of the mandible in front of the masseter, behind the facial artery |
| Neck | Joins branches of the retromandibular vein and continues to the internal jugular |
Unlike the facial artery, which is tortuous and follows the edge of the nose and the nasolabial fold, the vein takes a straighter and more lateral course. For that reason, in the midface, the two vessels move apart and come back together at the mandible.
How does it relate to the layers of the cheek?
In the midface, the facial vein runs in a deep plane, below the zygomaticus major muscle. It is described as a landmark for the boundary between deep compartments: it sits next to the lateral edge of the deep medial cheek fat and in front of the buccal fat pad (Bichat's fat pad). Lower down, it borders the premasseteric space. This relationship helps explain why planes and compartments are not interchangeable when assessing volume.
Why does the facial vein matter in HOF?
- Bruising and ecchymosis: it is a large-caliber vessel in the middle of the cheek and at the edge of the jaw. Venous bleeding in these areas usually results in a bruise (hematoma) or ecchymosis, with a higher chance in people taking anticoagulants or antiplatelet drugs.
- Connection to the skull: through the angular vein, it connects to the ophthalmic veins and the cavernous sinus; through the deep facial vein, to the pterygoid plexus. This explains the concept of the danger triangle of the face.
- Jawline: the point where the vein and artery cross the mandible, in front of the masseter, is a well-known anatomical landmark in procedures in this area.
How does it show up in the assessment?
- History of easy bruising and use of medications that affect coagulation.
- Palpation of the facial pulse at the edge of the jaw: it locates the artery, and the vein lies just behind it.
- Thin skin on the cheek: in some people, venous branches are visible through the skin.
- Previous procedures on the cheek and jaw, which change the local anatomy.
The topic of the areas that call for the most care is covered in vascular danger zones of the face.
Also called: anterior facial vein, vena facialis.
Frequently asked questions
What is the difference between the facial vein and the facial artery?
Both cross the face from the side of the nose to the jaw, but the artery is tortuous and more anterior, while the vein follows a straighter course, lateral and posterior to it. At the edge of the jaw, both pass in front of the masseter muscle, with the vein behind the artery.
Does the facial vein have valves?
It is traditionally described as a valveless vein, which explains the possibility of flow in both directions and the connection to the cavernous sinus. More recent anatomical studies describe valves in some people, so the concept holds as a tendency, not an absolute rule.