title: Distribution Pattern of the Superior and Inferior Labial Arteries: Impact for Safe Upper and Lower Lip Augmentation Procedures.
abstract: BACKGROUND
  Understanding the precise position and course of the superior and inferior labial arteries within the upper lip and the lower lip is crucial for safe and complication-free applications of volumizing materials.
  
  
  METHODS
  One hundred ninety-three anatomical head specimens (56.5 percent female cadavers) of Caucasian ethnicity were investigated in this large multicenter anatomical study. In total, six 3-cm-long vertical incisions were performed on each lip (midline and 1 cm medial to the angles of the mouth) to identify the position of the superior and inferior labial arteries in relation to the orbicularis oris muscle.
  
  
  RESULTS
  Three different positions of the superior and inferior labial arteries were identified: submucosal (i.e., between the oral mucosa and the orbicularis oris muscle in 78.1 percent of the cases), intramuscular (i.e., between the superficial and deep layers of the orbicularis oris muscle in 17.5 percent of the cases), and subcutaneous (i.e., between the skin and the orbicularis oris muscle in 2.1 percent of the cases). The variability in changing the respective position along the labial course was 29 percent for the total upper and 32 percent for the total lower lip. The midline location was identified in both the upper and lower lips to be the most variable.
  
  
  CONCLUSIONS
  Based on the results of this investigation, a safer location for the application of volumizing material is the subcutaneous plane in the paramedian location of both the upper lip and the lower lip. Care has to be taken when aiming to inject in the midline, as the artery can be identified more frequently in superficial positions.
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Cotofana
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Bettina
authors.initials: B
authors.lastname: Pretterklieber
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Runhild
authors.initials: R
authors.lastname: Lucius
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Frank
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Haas
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Thilo L
authors.initials: TL
authors.lastname: Schenck
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Corinna
authors.initials: C
authors.lastname: Gleiser
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Imke
authors.initials: I
authors.lastname: Weyers
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Thilo
authors.initials: T
authors.lastname: Wedel
authors.affiliation: Roseau, Commonwealth of Dominica; Salzburg and Vienna, Austria; and Kiel, Munich, Tuebingen, and Luebeck, Germany.|From the Department of Anatomy, Ross University School of Medicine; the Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg; the Center of Anatomy and Cell Biology, Division of Anatomy, Medical University of Vienna; the Institute of Anatomy, Christian-Albrechts-University of Kiel; the Department of Hand, Plastic, and Aesthetic Surgery, Ludwig-Maximilians University; the Institute of Anatomy, Department of Clinical Anatomy and Cell Analysis, University of Tuebingen; and the Institute of Anatomy, University of Luebeck.
authors.forename: Michael
authors.initials: M
authors.lastname: Pretterklieber
mesh_terms: D000792:Angiography; D001158:Arteries; D002102:Cadaver; D003357:Cosmetic Techniques; D000067548:Dermal Fillers / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008046:Lip / Q000098:blood supply*; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D000067548:Dermal Fillers