{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:14:43Z","timestamp":1760058883352,"version":"build-2065373602"},"reference-count":21,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Anatomical knowledge of the arterial supply to the lower face is critical to prevent unnecessary harm to patients seeking cosmetic procedures, particularly lower lip dermal filler injections. Our study sought to characterize the prominent vascular structures of the lower lip: inferior labial (ILA), labiomental (LMA) and mental (MA) arteries. Methods: Forty-eight hemiface specimens from 30 formalin-embalmed donors were utilized in this study. Dissection was performed of the LMA, ILA, and MA to determine their diameter, branching pattern for characterization, and to assess their supply to the lip distally. Results: The ILA (mean diameter, 1.5 \u00b1 0.49 mm) was found to be prevalent in 90% of sampled donors. The LMA (1.2 \u00b1 0.53 mm) was found in 75% of donors. All 48 hemifaces were found to have a MA (1.6 \u00b1 0.51 mm). 88% of ILAs, 43% of LMAs, and 96% of MAs were identified as directly supplying the lower lip. Mean location of the MA as it supplied the lower lip was determined to be (\u221217 mm, \u22128.2 mm) and (20 mm, \u22128.1 mm) in the left and right hemifaces, respectively. F-Test for variance found no significant differences amongst the horizontal (p = 0.82) and vertical distances (p = 0.41) bilaterally. Conclusions: Our findings demonstrate the high variability in vascular supply of the lower lip, suggesting the need for high-resolution ultrasound guidance and the integration of anatomical training within injection courses for the safe injection of dermal fillers.<\/jats:p>","DOI":"10.3390\/jcm14093214","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T09:08:56Z","timestamp":1746522536000},"page":"3214","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Filling the Gap: Facial Anatomy and Safe Lower Lip Injection Practices"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9100-9307","authenticated-orcid":false,"given":"Makayla M.","family":"Swancutt","sequence":"first","affiliation":[{"name":"College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron J.","family":"Allard","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5577-6831","authenticated-orcid":false,"given":"Alex","family":"Ho","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0065-847X","authenticated-orcid":false,"given":"Sara","family":"Sloan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Anatomical Sciences, Kansas City University, Kansas City, MO 64106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,6]]},"reference":[{"key":"ref_1","unstructured":"American Society of Plastic Surgeons (2020). 2020 Plastic Surgery Statistics Report, American Society of Plastic Surgeons. Available online: https:\/\/www.plasticsurgery.org\/documents\/News\/Statistics\/2020\/plastic-surgery-statistics-full-report-2020.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"102643","DOI":"10.1016\/j.amjoto.2020.102643","article-title":"Beauty is in the eye of the follower: Facial aesthetics in the age of social media","volume":"41","author":"Eggerstedt","year":"2020","journal-title":"Am. J. Otolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e2399","DOI":"10.1097\/GOX.0000000000002399","article-title":"Translucent and ultrasonographic studies of the inferior labial artery for improvement of filler injection techniques","volume":"7","author":"Tansatit","year":"2019","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1097\/SCS.0b013e31816aaad4","article-title":"Anatomic dissection of the arterial supply of the lips: An anatomical and analytical approach","volume":"19","author":"Meguid","year":"2008","journal-title":"J. Craniofacial Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1002\/ca.23379","article-title":"Positional relationship of superior and inferior labial artery by ultrasonography image analysis for safe lip augmentation procedures","volume":"33","author":"Lee","year":"2020","journal-title":"Clin. Anat."},{"key":"ref_6","first-page":"276","article-title":"Injection necrosis of the glabella: Protocol for prevention and treatment after use of dermal fillers","volume":"32","author":"Glaich","year":"2006","journal-title":"Dermatol. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/ca.23007","article-title":"The facial artery: A comprehensive anatomical review","volume":"31","author":"Lee","year":"2018","journal-title":"Clin Anat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1111\/joa.13113","article-title":"The mental artery: Anatomical study and literature review","volume":"236","author":"Kikuta","year":"2020","journal-title":"J Anat."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/BF01628490","article-title":"Anatomy of the arterial vascularization of the lips","volume":"20","author":"Crouzet","year":"1998","journal-title":"Surg. Radiol. Anat."},{"key":"ref_10","first-page":"295","article-title":"Dermal fillers in aesthetics: An overview of adverse events and treatment approaches","volume":"6","author":"Funt","year":"2013","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Hong, G.W., Hu, H., Chang, K., Park, Y., Lee, K.W.A., Chan, L.K.W., and Yi, K.-H. (2024). Review of the adverse effects associated with dermal filler treatments: Part I Nodules, Granuloma, and Migration. Diagnostics, 14.","DOI":"10.3390\/diagnostics14151640"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e50403","DOI":"10.2196\/50403","article-title":"Hyaluronidase for dermal filler complications: Review of applications and dosage recommendations","volume":"7","author":"Kroumpouzos","year":"2024","journal-title":"JMIR Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2147\/CIA.S2135","article-title":"Hyaluronic acid gel fillers in the management of facial aging","volume":"3","author":"Brandt","year":"2008","journal-title":"Clin. Interv. Aging"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s00276-015-1447-2","article-title":"What is the difference between the inferior labial artery and the horizontal labiomental artery?","volume":"37","author":"Lee","year":"2015","journal-title":"Surg. Radiol. Anat."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1111\/jocd.15475","article-title":"Case series of tongue necrosis from vascular complications after chin augmentation with hyaluronic acid: Potential pathophysiology and management","volume":"22","author":"Thanasarnaksorn","year":"2023","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1002\/wjo2.126","article-title":"Facial fillers: Relevant anatomy, injection techniques, and complications","volume":"9","author":"Clark","year":"2023","journal-title":"World J. Otorhinolaryngol. Head Neck Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s00266-016-0725-7","article-title":"A dark side of the cannula injections: How arterial wall perforations and emboli occur","volume":"41","author":"Tansatit","year":"2017","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"51e","DOI":"10.1097\/PRS.0000000000006394","article-title":"Implication of location of the ascending mental artery at the chin injection point","volume":"145","author":"Tansatit","year":"2020","journal-title":"Plast. Reconstr. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1093\/asj\/sjab036","article-title":"Aspiration before tissue filler-an exercise in futility and unsafe practice","volume":"42","author":"Goodman","year":"2022","journal-title":"Aesthetic Surg. J."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Beiu, C., Popa, L.G., B\u0103l\u0103ceanu-Gur\u0103u, B., Iliescu, C.A., Racovi\u021b\u0103, A., Popescu, M.N., and Mihai, M.M. (2023). Personalization of minimally-invasive aesthetic procedures with the use of ultrasound compared to alternative imaging modalities. Diagnostics, 13.","DOI":"10.3390\/diagnostics13233512"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.2147\/CIA.S423373","article-title":"Vascular aging: Assessment and intervention","volume":"18","author":"Li","year":"2023","journal-title":"Clin. Interv. Aging"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3214\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:27:38Z","timestamp":1760030858000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,6]]},"references-count":21,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14093214"],"URL":"https:\/\/doi.org\/10.3390\/jcm14093214","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,5,6]]}}}