Topographic anatomy of the face: the ABC of injection cosmetology

Carrying out injectable cosmetology procedures requires a specialist to have perfect knowledge of the topographic anatomy of the face and neck.

Understanding the peculiarities of the location of nerve endings and vascular structures is necessary not only for the technically correct performance of manipulations, but also to prevent the development of formidable complications.

In this article on estet-portal.com you can get acquainted with the main principles of innervation and vascularization of the face, as well as the general aspects of the formation of age-related changes and mimic wrinkles of the periorbital region.

Innervation of the facial muscles: intraparotid plexus of the facial nerve

At the level of the ear, the intraparotid plexus of the VII cranial nerve is located. Branches depart from it, which are responsible for the innervation of exclusively facial muscles of the face, namely:

1.    Temporal branches – the anterior and superior ear muscles, as well as the muscles that surround the eye;

2.    Zygomatic branches - the large zygomatic muscle and the circular muscle of the eye;

3.    Buccal branches – of the same name muscle of the facial muscles located above the oral fissure;

4.    Marginal mandibular branch – facial muscles located below the oral fissure;

5.    Cervical branch – is part of the superficial loop of the neck (ansa cervicalis superficialis).

The above branches diverge in the form of rays, forming the so-called pes anserinus major – big crow's foot.

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Innervation of the muscles of the face: the main branches of the trigeminal nerve

The trigeminal nerve is the 5th cranial nerve and is responsible for both motor and sensory innervation of facial tissues.

The trigeminal nerve has three powerful branches:

1.    Ocular nerve – sensitive;

2.    Maxillary nerve – sensitive;

3.    Mandibular nerve – mixed, contains both sensory and motor fibers.

For a specialist working in the field of injection cosmetology, the topography of the ophthalmic nerve, in particular its branches – supratrochlear nerve.

The supratrochlear nerve is located above the block of the superior oblique muscle, innervates the medial and upper parts of the forehead.
Below the location of the supratrochlear nerve, being on the same vertical line with it, is the infraorbital nerve – powerful branch of the maxillary nerve.

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Even lower along this very vertical line is the mental branch of the mandibular nerve.
At the level of the junction of the upper jaw and the zygomatic bone, there is the zygomaticofacial nerve – branch of the maxillary nerve.

The cosmetologist must know and take into account the topographic anatomy of the above structures.

General principles of facial vascularization: facial and temporal arteries

The common carotid artery divides into the internal and external carotid arteries.

The internal carotid artery is responsible for the blood supply to the structures of the brain.

The external carotid artery tends to the angle of the lower jaw, where, at the level of the outer edge of the masticatory muscle, the facial artery departs from it.

In turn, branches depart from the facial artery, supplying the upper, lower lips and the tip of the nose.
On its way to the corner of the eye, the facial artery is renamed the so-called angular artery. The angular artery anastomoses with the dorsal artery of the nose – branch of the ophthalmic artery.

Another important terminal branch of the external carotid artery – superficial temporal artery, the pulsation of which is felt at the level of the tragus of the ear.

Aiming at the upper part of the face, the superficial temporal artery meanders, supplying blood to the temporal and parietal regions.

The most important is the anastomosis between the temporal and facial arteries, which is known as the transverse facial artery.

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Aspects of the formation of mimic wrinkles in the periorbital region

To understand the general principles of the formation of facial reactions, knowledge of muscle anatomy is necessary.

The following main mimic muscles of the periorbital region should be distinguished:

1.    Corugators – "pull" brow medially and down, creating the emotion of a frown. Corugators are responsible for the formation of vertical wrinkles in the area between the eyebrows;

2.    Muscle of the Proud – lowers the eyebrow down, at the level of the forehead it is more superficial, closer to the level of the nose it is deeper. Muscle of the proud – "culprit" formation of horizontal wrinkles in the area between the eyebrows.

3.    Circular muscle of the eye – has orbital, secular and lacrimal parts. The most important for cosmetologists is the orbital part, which is responsible for the formation of "crow's feet", and the secular part. Contraction of the upper eyelid part of the circular muscle of the eye leads to squinting.

Thus, these muscles are eyebrow depressors, that is, they are responsible for lowering them. In turn, the frontalis muscle is the elevator of the eyebrows.

The doctor performing injections in the periorbital and frontal area must take into account not only the dose of the injected drug, but also the depth of the needle insertion.

Thank you for staying with estet-portal.com. Read other interesting articles in the "Cosmetology" section. You may also be interested in: The human nose: a quick guide to structure and function