This study demonstrated that the most prominent areas of the vascular bridges were at the midline of the zygomatic arch and the lateral margin of the frontal process, and that great care should be taken in these vascularly dense areas during injection. The vascular zones anterior or posterior to the midline of the zygomatic arch were relatively safe injection areas, which we recommended for injection.
Zhao, Wei-Rui M.D.; Duan, Jing M.D.; Chen, Chun-Lin M.D.; Luo, Cheng-En; Zhan, Wen-Feng M.D.; Kong, Xiang-Xue M.D., Ph.D.; Luo, Sheng-Kang M.D., Ph.D.
Author Information Plastic and Reconstructive Surgery: February 2021 – Volume 147 – Issue 2 – p 328-336doi: 10.1097/PRS.0000000000007519
Background:
Injection-based techniques for “cheek augmentation” have gained popularity in recent years. The aim of this study was to perform a topographic analysis of the depth and distribution of the vessels in the zygomatic region to facilitate clinical procedures.
Methods:
The external carotid arteries of seven cadaveric heads were infused with lead oxide contrast medium. The facial and superficial temporal arteries of another 12 cadaveric heads were injected sequentially with the same medium. Computed tomographic scanning was then performed, and three-dimensional computed tomographic scans were reconstructed using validated algorithms.
Results:
The vessels on the zygomatic arch received a double blood supply from across the upper and lower borders of the arch, and the number of the vessels varied from one to four. Ninety percent of the vessels on the zygomatic arch were at a depth of 1 to 2.5 mm, and 75 percent were at a depth of 10 to 30 percent of the soft-tissue thickness. The vessels were concentrated on the midline of the zygomatic arch and the lateral margin of the frontal process. All samples showed a vessel travel along the lateral margin of the frontal process that eventually merged into the superior marginal arcades.
Conclusions:
This study reported a topographic analysis of the depth and distribution of the vessels in the zygomatic region based on three-dimensional scanning. The results indicated that injection on the zygomatic arch should be performed deep to the bone, and the vascular zones anterior or posterior to the midline of the zygomatic arch were relatively safe injection areas.
The vessel frequency represented by area A was 50 percent; area B, 25 percent; area C, 16.7 percent; and area D, 8.3 percent. Thus, the vascular bridges were present most frequently in area A.