Study analyses the clinical relevance of the infraorbital artery in aesthetic medicine to identify danger zones

A study published in the Journal of Plastic Reconstructive Aesthetic Surgery has set out to define the vascular danger zones of the infraorbital area in order to provide guidelines helping to avoid them. 

Complications such as arterial embolism and occlusion can occur even with experienced injectors, especially in high-risks zones such as the glabella, the nasal dorsum or the nasolabial fold. 

The infraorbital artery, its main branches and their anastomoses with neighbouring vessels, were studied in 18 fresh cadavers. Mimetic injections of inked hyaluronic acid were performed in the infraorbital area in the interest of analysing its distribution and to determine potential vascular risks towards the infraorbital artery and its branches. 

Two danger zones could be depicted: injections can be risky when performed too superficially in the midcheek area, and likewise when performed in a periosteal layer in infraorbital hollow or tear-trough correction, because of an obvious possibility of retrograde embolism. 

The study concluded that the infraorbital artery can be involved in anatomic mechanism of arterial occlusion, further blindness and stroke, among the related neighbouring arteries. “Based on the findings of this study, injections to the periosteum layer in tear-trough correction and above the periosteum on the zygomatic arch are not advised”, the authors said.