Arterial anatomy of the nasolabial flap

By using stereographic angiograms, the three dimensional structures of skin perforators originating from the facial, lateral nasal, dorsal nasal, angular, infraorbital, and transverse facial arteries were observed. In the nasolabial fold, many small arterial vessels ascended through the superficial adipofascial layer above the facial expression muscles, and an intimate deep dermal plexus was formed. However, the horizontal continuity of blood vessels in the superficial adipofascial layer was poor. Based on this anatomy, the nasolabial flap, which usually gets elevated above the facial expression muscles, should be elevated as a local flap along with the skin pedicle or as a V-Y advancement flap.