The localization and topography of the arteries on the middle forehead region for eluding complications following forehead augmentation: Conventional cadaveric dissection and ultrasonography investigation

다국어 초록 (Multilingual Abstract)

Forehead augmentation with filler injection is one of the most dangerous procedures associated with iatrogenic intravascular injection resulting in the severe complications. Nonetheless, few studies have determined the explicit arterial localization and topography related to the facial soft tissues and landmarks. Therefore, this study aimed to determine an arterial distribution and topography on the middle forehead region correlated with facial landmarks to grant an appropriate guideline for enhancing the safety injection. The research procedures of this study were approved by the Institutional Review Board of the Faculty of Medicine, Chulalongkorn University (IRB No. 786/61, COA No. 149/2019) and conducted in accordance with the Declaration of Helsinki of the World Medical Association (WMA). Cadaveric dissection and ultrasonographic investigation in healthy volunteers were employed to study the forehead region. The cadavers were legally donated for medical education and research, and the participants have signed the informed consent prior to the ultrasound operation. Nineteen Thai embalmed cadavers were discovered with conventional dissection and 14 Thai healthy volunteers were investigated with ultrasonographic examination on the middle forehead. At the level of mid‐frontal depression point, the transverse distance from the medial canthal vertical line to the supraorbital artery were 9.1 mm (superficial branch) and 15.1 mm (deep branch). The depths from skin of the artery were 4.1 mm (superficial branch), and 4.3 mm (deep branch). Furthermore, the frontal branch of superficial temporal artery was detectable in 42.1% as an artery entering the forehead area. At the level of lateral canthal vertical line, the vertical distance of frontal branch was 31.6 mm, and the depth from skin of the artery was 2.7 mm. In conclusion, a proper injection technique could be performed based on an intensive arterial distribution and topography, and ultrasonographic examination prior to the injection is also suggested in order to restrict the opportunity of severe complications.
This presentation was supported by Overseas academic presentation scholarship from Faculty of Medicine Vajira Hospital, Navamindradhiraj University.