THE ARTERIAL SUPPLY OF THE FACE LIFT FLAP

The cutaneous arterial circulation of the face lift flap was investiga ted using multiple anatomic techniques in fresh cadaver specimens. Per foration sites of the transverse facial and submental arteries were pr eserved or transected according to protocol during bilateral rhytidect omy prior to selective injections with ink or lead oxide. It was obser ved that the transverse facial perforating artery provides the major d irect blood supply to the lateral cheek and preauricular area followin g rhytidectomy if preserved. This perforator occupies a constant anato mic location 3.1 cm lateral and 3.7 cm inferior to the lateral canthus with 95 percent tolerance limits of +/-1.1 cm. There is greater varia bility in localizing the submental perforating artery; however, this p erforator also contributes significantly to lateral facial blood suppl y. Both perforator locations are within the area of ''standard'' under mining for rhytidectomy; however, they may be preserved during this pr ocedure if desired. Transection of the lateral facial perforators leav es vascularization of these cutaneous areas dependent on collateral fl ow from the pedicle of the face lift flap. The ability to preserve opt imal blood supply to the lateral face lift flap may be useful in the c linical setting of a vascularly compromised or smoking patient.