A comprehensive classification and depth analysis of the transverse facial artery based on cadaveric and radiological evidence

Abstract

The transverse facial artery is a key vascular structure supplying the lateral face and is critically important in surgical procedures such as facelifts, facial trauma repair, and injectable treatments. However, detailed anatomical studies on the transverse facial artery remain scarce. This study aimed to comprehensively evaluate the anatomical variations, depth, branching patterns and clinical significance of the transverse facial artery (TFA) using both cadaveric dissection and computed tomography angiography (CTA). This study employed a dual-modality design, combining cadaveric dissection of 40 hemifaces and computed tomography angiography of 180 hemifaces. Parameters analyzed included the artery's origin, course, length, depth from the skin surface, and branching pattern. The transverse facial artery was classified according to its origin, branching, and topographic course. In cadaveric specimens, a single transverse facial artery was present in 87.5% of cases, most commonly originating from the superficial temporal artery (90%) and less frequently from the external carotid artery (5%). Imaging revealed a single artery in 91.1% of cases, with 83.3% originating from the superficial temporal artery, 3.9% directly from the external carotid artery, and 12.8% from its bifurcation. Six branching types and three course-based zones were defined, with the superior zone being the most frequent (65%). The artery was significantly deeper in the inferior zone (p < 0.05). In this study, we report for the first time the measurement of the depth of the TFA from the skin surface, with a mean value of 10.54 mm. This comprehensive anatomical and morphometric evaluation provides clinically relevant insights into transverse facial artery variability. The findings offer a refined classification and practical guidance to support safer surgical and aesthetic procedures.

Keywords: Arterial classification; Cadaveric dissection; Facial anatomy; Transverse facial artery; Vascular variation.