Subdermal plexus: the vascular network under the skin
Quick facts
- Definition
- Network of small arteries and veins at the junction between the dermis and the subcutaneous tissue.
- Function
- Nourishes the skin and regulates temperature, with connections to deeper vessels.
- Relevance in HOF
- Injury or occlusion can cause bruising, skin ischemia and, in severe cases, necrosis.
- Critical areas
- The glabella, nose and lips have little circulatory reserve.
The subdermal plexus is the network of small blood vessels found at the junction between the dermis and the subcutaneous tissue. It nourishes the skin, regulates temperature and links deeper vessels to more superficial ones. In orofacial harmonization (HOF), it is the point where superficial injections meet the skin's circulation.
How is the skin supplied with blood?
Blood supply to the skin of the face is organized in layers of plexuses, which communicate through perforating vessels.
| Level | Description |
|---|---|
| Perforating vessels | Cross muscle and fat and reach the skin |
| Subdermal plexus | Larger-caliber network at the base of the dermis |
| Superficial dermal plexus | Fine network under the epidermis |
| Capillaries | Loops that nourish the epidermis |
The communication between vessels, the vascular anastomosis, is abundant in the face. That is an advantage for healing, but it also means an occlusion at one point can show up in distant areas.
Why does it matter in superficial procedures?
Any injection that crosses the skin passes through the subdermal plexus. In shallow planes, such as the intradermal and subcutaneous planes, the product sits very close to it, and that has consequences.
- Hematoma and ecchymosis: injury to small vessels is the most common cause of bruises after injection. They are usually self-limited.
- Vasospasm: manipulation can make a vessel contract, causing temporary paleness. See vasospasm.
- Ischemia: if the product compresses or fills the vessel, the skin can turn pale, then purplish and painful.
- Necrosis: in severe cases, the lack of circulation progresses to tissue death. See necrosis and vascular occlusion.
- Telangiectasias: persistent fine vessels can become visible after trauma. See telangiectasia.
Which areas need the most attention?
The glabella, the nose and the lips have relatively little circulatory reserve and anastomoses that can carry a problem to sensitive areas. The thin skin around the eyes also has little margin. In these areas, the professional should know the vascular territory, use a technique that matches their own experience and keep the emergency plan within reach.
Also called: subdermal vascular network, deep vascular plexus of the dermis.
Frequently asked questions
Is the subdermal plexus visible?
Partly. Fine veins can show through in fair, thin skin. The network itself is mostly microscopic, but injury to it can result in visible patches and bruising.