Facial Artery

The facial artery is a major artery of the superficial face and one of the principal branches of the external carotid artery. It has a characteristic tortuous course that allows it to accommodate movements of the mandible, lips, and cheeks.

From a surface anatomy perspective, the most important landmark is where the facial artery crosses the inferior border of the mandible immediately anterior to the masseter muscle. At this point the vessel can often be compressed against the mandible and its arterial pulse can be palpated.

After entering the face, the artery passes toward the angle of the mouth and then ascends along the side of the nose toward the medial angle of the eye.

Origin

The facial artery usually arises from the external carotid artery within the carotid triangle of the neck.

Its origin is typically superior to the lingual artery, although anatomical variations occur, including a common linguofacial trunk.

Cervical Course

After arising in the neck, the facial artery passes superiorly and anteriorly in relation to structures of the submandibular region.

It courses deep to structures associated with the mandible before curving around the lower border of the mandible to enter the face.

Relationship to the Submandibular Gland

The facial artery is closely related to the submandibular gland.

It commonly grooves or passes through the posterior aspect of the gland before emerging toward the inferior border of the mandible.

Entry into the Face

The artery enters the face by winding around the inferior border of the mandible.

This occurs just anterior to the anterior border of the masseter muscle and provides the most useful surface landmark for the vessel.

Facial Artery Pulse

The facial artery pulse can be palpated where the artery crosses the mandible anterior to the masseter.

The vessel is gently compressed against the underlying bone using the fingertips.

How to Locate the Facial Artery Pulse

1. Identify the inferior border of the mandible.
2. Palpate the anterior border of the masseter muscle.
3. Move slightly anterior to the masseter along the lower border of the mandible.
4. Apply gentle pressure against the mandibular surface.
5. Feel for the arterial pulsation.

Masseter Landmark

The masseter is an important landmark because the facial artery crosses the mandible immediately anterior to it.

Clenching the teeth can make the masseter more prominent and help identify its anterior border.

Mandibular Landmark

The inferior border of the mandible provides a firm bony surface against which the artery can be compressed.

This makes the mandibular crossing one of the easiest locations for identifying the facial artery externally.

Facial Course

After crossing the mandible, the facial artery follows an oblique and tortuous course across the face.

It travels toward the region of the angle of the mouth, then ascends along the side of the nose toward the medial angle of the eye.

Tortuous Course

The facial artery is noticeably tortuous rather than straight.

This configuration permits the vessel to accommodate movements associated with facial expression, speaking, chewing, and changes in the position of the mandible.

Surface Projection

The surface course of the facial artery can be approximated from its mandibular crossing anterior to the masseter toward the angle of the mouth, then upward beside the nose toward the medial orbital region.

The actual vessel course varies between individuals and may not correspond exactly to a straight surface line.

Relationship to the Angle of the Mouth

The facial artery passes close to the angle of the mouth, where it gives branches supplying the lips and surrounding tissues.

This region is highly vascular because of extensive arterial connections between vessels on both sides of the face.

Relationship to the Nose

The artery ascends alongside the nose after passing the oral region.

Branches from this portion contribute to the blood supply of the nose and adjacent facial tissues.

Angular Artery

The terminal portion of the facial artery near the medial angle of the eye is commonly called the angular artery.

It participates in vascular connections with branches of the ophthalmic arterial system.

Major Facial Branches

Branch	General Distribution
Inferior labial artery	Lower lip
Superior labial artery	Upper lip and adjacent nasal region
Lateral nasal artery	Side and ala of nose
Angular artery	Upper lateral nose and medial orbital region

Inferior Labial Artery

The inferior labial artery supplies the lower lip and participates in arterial anastomoses across the midline.

Its course is related to the tissues of the lower lip and surrounding muscles of facial expression.

Superior Labial Artery

The superior labial artery supplies the upper lip and gives branches toward the nasal septum and adjacent nasal tissues.

It anastomoses with the corresponding artery from the opposite side.

Lateral Nasal Artery

The lateral nasal artery supplies portions of the external nose.

It communicates with neighboring branches from the facial and ophthalmic arterial systems.

Angular Artery and Ophthalmic Circulation

The angular artery can communicate with branches derived from the ophthalmic artery, including vessels near the medial orbital region.

This creates an arterial connection between branches of the external and internal carotid systems.

Cervical Branches

Before entering the face, the facial artery gives branches in the neck that supply structures of the upper neck and oral floor region.

These commonly include the ascending palatine, tonsillar, submental, and glandular branches.

Submental Artery

The submental artery is an important cervical branch of the facial artery.

It runs forward in the submental region and supplies structures around the floor of the mouth, submandibular region, and chin.

Relationship to Facial Muscles

The facial artery passes through a region containing numerous muscles of facial expression.

Its depth relative to individual muscles varies along its course as it supplies the highly mobile soft tissues of the face.

Relationship to the Buccinator

In the cheek, the facial artery lies superficial to the buccinator as it passes toward the oral commissure.

This relationship helps distinguish its course from deeper structures of the oral cavity.

Relationship to the Facial Vein

The facial vein generally follows a straighter course than the facial artery.

It typically lies posterior to the artery across much of the face rather than accompanying every arterial curve closely.

Facial Artery Versus Facial Vein

Feature	Facial Artery	Facial Vein
Course	Tortuous	Relatively straight
Pulse	Palpable at mandibular crossing	Non-pulsatile
General facial relationship	More anterior	Generally posterior to artery
Primary role	Arterial supply	Venous drainage

Arterial Anastomoses

The face has an extensive network of arterial anastomoses.

The facial artery communicates with branches of the opposite facial artery and with branches from other arteries, including the transverse facial, infraorbital, mental, and ophthalmic arterial systems.

External Carotid System

The facial artery is part of the external carotid arterial system.

Most of its branches supply extracranial structures of the face, oral region, and superficial tissues.

Relationship to the External Carotid Artery

The external carotid artery gives rise to several branches supplying the face and neck.

The facial artery is distinguished by its extensive course across the superficial face after leaving the cervical region.

Blood Supply Territory

The facial artery contributes to the arterial supply of:

• Submandibular region
• Floor of the mouth
• Chin
• Cheek
• Upper and lower lips
• External nose
• Medial facial region near the eye

Surface Anatomy Variability

The facial artery shows substantial anatomical variation in its branching pattern and terminal extent.

In some individuals it reaches the medial orbital region, while in others its terminal branches may be less extensive and neighboring arteries contribute more strongly to the upper face.

Clinical Significance

Pulse Palpation

The mandibular crossing provides a convenient location for palpating the facial artery.

This point is particularly useful for demonstrating the vessel in surface anatomy because the artery can be compressed against bone.

Control of Bleeding

Because the facial artery crosses the mandible superficially, pressure at this point can reduce arterial flow to portions of the face supplied distally by the vessel.

Extensive collateral circulation means that bleeding may still receive blood from communicating arterial branches.

Facial Lacerations

The rich arterial supply of the face can cause facial wounds to bleed substantially.

At the same time, the abundant vascular network contributes to the generally strong healing capacity of facial tissues.

Facial Surgery

Knowledge of the facial artery's course is important during surgery involving the mandible, cheek, lips, nose, and reconstructive facial tissues.

The vessel's variable and tortuous course means that precise localization may require direct visualization or imaging.

Reconstructive Flaps

The facial artery and its branches can provide vascular pedicles for selected local and regional reconstructive flaps.

Detailed knowledge of the arterial course and anatomical variation is important when planning such procedures.

Facial Artery Imaging

Doppler ultrasound and angiographic techniques can demonstrate the location, direction of flow, and branching pattern of the facial artery.

Imaging is particularly useful when precise vascular mapping is required.

Cosmetic Procedures

The variable course of facial arteries is clinically relevant during injections and other procedures involving facial soft tissues.

Understanding vascular anatomy helps identify regions where major vessels may be encountered.

Relationship to the Mandibular Notch and Angle

The palpable facial artery crossing occurs along the body of the mandible, anterior to the masseter, rather than at the mandibular notch or directly at the angle of the mandible.

Distinguishing these landmarks improves surface localization.

Relationship to the Oral Commissure

The artery passes near the oral commissure, the lateral junction of the upper and lower lips.

Its labial branches form extensive arterial networks within the lips.

Relationship to the Medial Canthus

The terminal facial arterial pathway approaches the medial canthus, or medial angle of the eye.

Here, the angular artery participates in anastomoses with vessels associated with the orbit.

Key Surface Anatomy Features

Feature	Key Point
Parent artery	External carotid artery
Major palpable landmark	Inferior border of mandible
Relationship at mandibular crossing	Immediately anterior to masseter
Course on face	Tortuous and generally superomedial
Important intermediate landmark	Angle of mouth
Terminal region	Medial angle of eye
Terminal branch	Angular artery
Major lip branches	Superior and inferior labial arteries
Associated cervical structure	Submandibular gland
Surface clinical feature	Pulse can be palpated against mandible

Anatomical Importance

The facial artery is an important vessel in surface anatomy of the face because part of its course can be related directly to palpable external landmarks. Its passage around the inferior border of the mandible immediately anterior to the masseter provides a particularly useful point for locating the artery and feeling its pulse.

After entering the face, its tortuous course reflects the mobility of the tissues it supplies. The artery passes toward the oral commissure and side of the nose before its terminal pathway approaches the medial angle of the eye. Along this route, its branches supply the lips, cheek, nose, and surrounding facial structures.

The facial artery's superficial position, extensive anastomoses, and variable branching pattern make it clinically important in facial trauma, surgery, reconstruction, vascular imaging, and other procedures involving the soft tissues of the face.