Vascular anastomosis: why the face has a network of vessels
Quick facts
- Definition
- A connection between two blood vessels, forming a network.
- Normal function
- Ensures alternative blood supply when one path is blocked.
- In the face
- Links the external carotid and internal carotid systems.
- Risk in HOF
- Allows an embolus to travel along unexpected paths.
- Critical areas
- Glabella, nose, tear trough, temples, upper nasolabial fold.
An anastomosis is a connection between two vessels. In normal circulation it is an advantage: if one path stops, blood goes another way. The face has many anastomoses, between the two sides and between the territories of different arteries, which contributes to good healing of the face.
Where do anastomoses matter most in HOF?
The most cited one links the territory of the external carotid artery, which gives rise to the facial artery, with that of the internal carotid, from which the ophthalmic artery arises. The angular artery, the end of the facial artery, meets branches of the ophthalmic near the inner corner of the eye, and vessels of the glabella and temples make similar connections.
What does this mean in practice?
The same network that protects the tissue can carry injected material. If a dermal filler enters an artery, the pressure of the injection can push it against the current to smaller-caliber vessels, such as those supplying the retina, and the effect appears far from the needle site. The condition is vascular occlusion with embolism.
How does the network enter planning?
- Know the course of the vessels and the anatomical variation between people.
- Explain to the patient that the risk is rare, but exists, in the informed consent.
- Prefer conservative volumes in these areas and watch for signs during injection.
- Keep an emergency protocol ready.
Anatomy varies, and no map replaces attention to each patient.
Also known as: facial vascular network, arterial communication.
Frequently asked questions
Why can filler in the nose affect the eye?
Because the vessels of the nose communicate with branches of the ophthalmic artery through anastomoses. Material that enters a vessel can be carried, against the direction of flow, to the circulation of the eye.