Facial anatomy

Abstract

Dermatologic problems of the face affect both function and aesthetics, which are based on complex anatomical features. Treating dermatologic problems while preserving the aesthetics and functions of the face requires knowledge of normal anatomy. When performing successfully invasive procedures of the face, it is essential to understand its underlying topographic anatomy. This chapter presents the anatomy of the facial musculature and neurovascular structures in a systematic way with some clinically important aspects. We describe the attachments of the mimetic and masticatory muscles and emphasize their functions and nerve supply. We highlight clinically relevant facial topographic anatomy by explaining the course and location of the sensory and motor nerves of the face and facial vasculature with their relations. Additionally, this chapter reviews the recent nomenclature of the branching pattern of the facial artery.

Sense: An Interactive Learning Application That Visualizes the Nerve Supply of Face

“…It is in the parotid gland, where this nerve gives off branches. There are five branches of facial nerve namely, the temporal, zygomatic, buccal, marginal mandibular and cervical branches [14].…”

The Proprioception in the Muscles Supplied by the Facial Nerve

“…To understand the proprioceptive innervation of the facial muscles, it is necessary to know as they are innervated by CNVII branches and as terminal segments of the facial nerves contain sensory fibers coming from CNV that provide these muscles with proprioceptive fibers, although individual differences may exist. The innervation of the facial muscles is summarized in Figure 2 [46].…”

A conceptual framework for navigating the superficial territories of the face: Relevant anatomic points for the dermatologic surgeon

“…3. The facial nerve is the principal motor supplier of the muscles of facial expression (mimetic muscles), primarily innervating them through their deep surfaces (Standring, 2008;Marur et al, 2014). 4.…”

“…In this region, the branches lie deep to the SMAS and for procedures that are performed no deeper than the skin the facial nerve branches are less likely to be injured. Fortunately, these transition points are somewhat predictable and there is a growing bank of literature that provides detailed morphometric data to determine location and safe zones for minimizing risk for injury (Liebman et al, 1982;Ishikawa, 1990;Pogrel et al, 1996;Larrabee and Henderson, 2000;Zani et al, 2003;Kwak et al, 2004;Standring, 2008;Odobescu et al, 2012;Mendelson and Wong, 2013;Brown et al, 2014;Marur et al, 2014;Roostaeian et al, 2015). A brief account of these branches is presented below and more detailed description of their course is described in the relevant sections of the anatomic zones, (Fig.…”

“…There are a few basic concepts that remain crucial to understanding and predicting the challenges that accompany surgical manipulation of the superficial face: The face can be dissected through principle fascial planes: skin, subcutaneous fibroadipose layer, superficial musculoaponeurotic system (SMAS) plane, and deep fascial plane (Delmar, ; Mendelson and Wong, ). Muscles of facial expression attach to the dermis of the skin, are reinforced by retaining ligaments and arranged within a stepped configuration (Mendelson and Wong, ). The facial nerve is the principal motor supplier of the muscles of facial expression (mimetic muscles), primarily innervating them through their deep surfaces (Standring, ; Marur et al, ). The motor branches of the facial nerve exit the parotid fascia along its anterior margin, travel from a deep to superficial plane and lie deep to the SMAS plane (Zani et al, ). The SMAS splits to enclose the muscles of facial expression and is continuous with platysma, superficial parotid fascia, galea aponeurotica and superficial temporal fascia (temporoparietal fascia) (Ghassemi et al, ). The sub‐SMAS plane is a relatively avascular plane (Ghassemi et al, ). The trigeminal nerve branches exit the supraorbital, infraorbital and mental foramina and travel from deep to superficial direction toward the skin where they lie within the sub‐cutaneous fibroadipose layer (Randle et al, ; Standring, ; Sinnatamby, ; Yang et al, ). The facial artery and its branches travel deep to the SMAS and run along a superficial course to cross palpable bony boundaries or perforate the SMAS(Ishikawa, ; Coscarella et al, ). The facial nerve branches divide into a variable number of rami and in the mid lateral face form a plexus of interconnected communications (Zani et al, ; Roostaeian et al, ). Thickness of the subcutaneous layer varies significantly and form cosmetic units based on the distribution of fat compartments (more uniform in thickness over the scalp yet compaction of the subcutaneous tissue around the eyelids and lips appear to make this layer almost non‐existent) (Delmar, ; Erdogmus and Govsa, ; Turvey and Golden, ; Mendelson and Wong, ). …”