Lower Nose Arterial Plexus and Implications for Safe Filler Injections

Background: The lower nose has abundant blood supply; however, nasal tip necrosis still occurs following filler injections. This study revealed the complicated pattern of the arterial supply of the lower nose. Methods: The arterial pattern of the lower nose was studied in 40 cadavers using conventional dissections and translucent modified Sihler’s staining. Results: Two arterial rings were connected in a figure of eight. The upper ring: nasal arterial circle (NAC) consisted of the lateral nasal and the subalar arteries encircling the nasal tip and alae. The lower ring: arterial plexus of the upper lip (ULP) was more important because of the contribution of the facial and superior labial arteries. This specific feature had not been mentioned elsewhere. Conclusion: Understanding this specific feature of the blood supply of the lower nose would be essential for aesthetic physicians to be aware and perform the appropriate techniques during the filler injection procedures in the nasal and perioral regions.