The submental artery flap: an anatomic study

Abstract

Coverage of facial defects is frequently challenging. Despite the numerous flaps described, the search for additional flaps with good color match and minimal donor-site morbidity continues. We present a flap based on the submental vessels. The anatomy based on 24 fresh cadaver dissections injected with Microfil is outlined. The submental artery is a branch of the facial artery after it exits from the submandibular gland. It runs over the mylohyoid and below the mandible. It continues either superficial or deep to the anterior belly of the digastric muscle. It supplies the skin of almost the entire triangle of the neck and a variable area across the midline. The facial artery diameter is 2.0 to 2.8 mm, and that of the submental artery is 1.0 to 1.5 mm. The facial vein provides venous drainage. From the anatomic study, the submental artery flap appears to have a long vascular pedicle and should be useful in facial and intraoral reconstructions. The size of the pedicle also makes it attractive as a free-tissue transfer. We feel that this flap has great clinical potential.