Resumo

Objectives: Problems understanding upper lip vascularity still persists. This study attempts to investigate vascular system of upper lip to bring improvements in flap design and procedure safety. Introduction: The vogue in today’s world of extensive use of different procedures in the upper lips requires a thorough understanding of its vascular pattern and distribution. In the literature, there was confusion in many aspects. The following needed clarification: - the names of the same branches are many (superficial ascending branches are also septal, subseptal or philtral branches), the description of vascular distribution pattern is not uniform among all authors, the topography of branches of SLA has not been understandably mentioned, and venous system has not been clearly described. Materials / method: The study comprised of seven cadaveric heads where the superior labial arteries and all their branches, the lateral nasal arteries as well as the inferior alar arteries were dissected. New nomenclature was designated to ease description. The point of origin, diameter, length, course, relationships and their termination were noted and analyzed. The veins encountered were also dissected and noted. Results: Vascular pattern resembled an infinity loop within intramuscular or submucosal planes. The superior labial arteries provided primary, secondary, intramuscular, submucosal, philtral and paraphiltral branches. There were 20.42 arteries per lip with 8.42 per philtrum. Philtral arteries were significantly larger than paraphiltral with mean diameter and length of 0.55mm and 18.75mm, respectively. Labial bisectors and labial tubercle were origin for 31.26% and 48.23% of the branches, respectively. Veins as superior labial veins averaged diameter and length of 0.73mm and 17.62mm, respectively. Conclusion: Our study revealed the infinity and dual plane design of vascular distribution, new nomenclature of primary and secondary, intramuscular and submucosal, and philtral and paraphiltral branches, consistent location of origin of these branches, high vascular density with double trident formation in the philtrum which can clearly guide any practitioner in understanding and performing various aesthetic as well as reconstructive procedures in the upper lip.