This study was undertaken to evaluate the blood supply to the facelift
flap by identifying the perforating arteries in the anterior facial r
egion, which is preserved during the undermining of the flap. We have
called this medial zone the pedicle area of the flap. Eleven pairs of
musculocutaneous perforator arteries supplying the facelift flap were
identified, all of them emerging from three main arterial trunks: the
facial, the superficial temporal, and the ophthalmic arteries. A rich
anastomotic network connected all the vessels; however, we were able t
o group this network into five basic forms including the ipsilateral a
nd contralateral external and internal carotid arteries. We found thes
e anastomotic links to be constant. We propose that this anatomical fe
ature of the face provides for adequate blood supply even when certain
regions have been altered by previous dissection, injury, or congenit
al deformity. This study confirms previous anatomical findings but als
o adds specific information regarding the blood supply to the facelift
flap that will allow this procedure to be carried out with maximum sa
fety and effectiveness.