title: Vascular Perfusion of the Facial Skin: Implications in Allotransplantation of Facial Aesthetic Subunits.
abstract: BACKGROUND
  As the field of face transplantation develops, it may be possible to transplant segments of facial skin to replace facial aesthetic subunits in selected cases. The aim of this study was to identify the more reliable vascular pedicles of each facial aesthetic subunit for its use in transplantation METHODS:: Six full facial soft-tissue flaps were harvested, and the external carotid artery was identified and cannulated proximal to the facial artery. Next, radiopaque contrast was injected through the facial artery into three of the facial flaps and through the superficial temporal artery in the other three facial flaps. After vascular injections, three-dimensional computed tomographic arteriographs of the faces were obtained, allowing analysis of the arterial anatomy and perfusion in different facial aesthetic subunits.
  
  
  RESULTS
  The chin, lower lip, upper lip, medial cheek, nose, and periorbital units were perfused in all facial flaps where the facial artery was injected and in none of those where the superficial temporal artery was injected. The lateral cheek was perfused in 100 percent of the superficial temporal artery flaps and in 67 percent of the facial artery flaps. The lateral forehead contained contrast in 100 percent of the superficial temporal artery-injected flaps and in none of the facial artery-injected flaps, and the medial foreheads contained contrast in 67 percent of the facial artery-injected flaps and in 67 percent of the superficial temporal artery-injected flaps.
  
  
  CONCLUSIONS
  The majority of the facial subunits can be harvested based on the facial artery pedicle, with the exception of the lateral forehead, which is based on the superficial temporal artery.
authors.affiliation: Uppsala, Sweden; and Dallas, Texas.|From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital; the Department of Surgical Sciences, Uppsala University; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Andrés
authors.initials: A
authors.lastname: Rodríguez-Lorenzo
authors.affiliation: Uppsala, Sweden; and Dallas, Texas.|From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital; the Department of Surgical Sciences, Uppsala University; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Thorir
authors.initials: T
authors.lastname: Audolfsson
authors.affiliation: Uppsala, Sweden; and Dallas, Texas.|From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital; the Department of Surgical Sciences, Uppsala University; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Corrine
authors.initials: C
authors.lastname: Wong
authors.affiliation: Uppsala, Sweden; and Dallas, Texas.|From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital; the Department of Surgical Sciences, Uppsala University; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Daniel
authors.initials: D
authors.lastname: Saiepour
authors.affiliation: Uppsala, Sweden; and Dallas, Texas.|From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital; the Department of Surgical Sciences, Uppsala University; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Daniel
authors.initials: D
authors.lastname: Nowinski
authors.affiliation: Uppsala, Sweden; and Dallas, Texas.|From the Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital; the Department of Surgical Sciences, Uppsala University; and the Department of Plastic Surgery, University of Texas Southwestern Medical Center.
authors.forename: Shai
authors.initials: S
authors.lastname: Rozen
mesh_terms: D064591:Allografts; D002102:Cadaver; D002342:Carotid Artery, External / Q000000981:diagnostic imaging; D002610:Cheek / Q000098:blood supply; D002680:Chin / Q000098:blood supply; D000072226:Computed Tomography Angiography; D003287:Contrast Media; D005145:Face / Q000098:blood supply*; D054445:Facial Transplantation / Q000379:methods*; D005546:Forehead / Q000098:blood supply; D006801:Humans; D021621:Imaging, Three-Dimensional; D008046:Lip / Q000098:blood supply; D061330:Multidetector Computed Tomography; D009666:Nose / Q000098:blood supply; D013524:Surgical Flaps / Q000098:blood supply*; D013699:Temporal Arteries / Q000000981:diagnostic imaging
chemical_list: D003287:Contrast Media