Chapter 3. Vascularity: Arterial Supply
The vascular supply and lymphatics of the nose are found superficial to the musculature. Dissection during rhinoplasty in the proper areolar tissue plane below the muscles preserves blood supply to the periphery and minimizes postoperative ecchymosis and swelling.
Externally, the anterior ethmoidal artery and the superior labial artery, as well as nasal branches from the infraorbital artery and the angular branch of the facial artery provide vascularity to the nose (Figure 3-1). The infraorbital branch of the internal maxillary artery and the ophthalmic branches of the internal carotid system supply the more dorsal regions.
Figure 3-1. Arterial supply to the nose.
The lateral nasal artery is a branch of the angular artery and is considered the most important contributor to the cutaneous blood supply of the nasal tip. This artery is located 2 mm to 3 mm above the alar groove. If an alar base excision is to be performed in an open rhinoplasty, it is important to make sure the incision does not extend beyond the alar groove.1
Internally, the vascular supply of the medial and lateral walls of the nasal cavity (Figures 3-2 and 3-3) arises from several arterial systems:
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