Research Article| Volume 60, ISSUE 3, P241-245, March 2007

Download started.


The arterial anatomy of the eyelid: importance for reconstructive and aesthetic surgery

Published:November 20, 2006DOI:



      The aim of the study was to investigate the arterial distribution of the eyelids.


      The location, course, length and diameter of eyelid arteries were determined in 19 preserved and latex injected adult male cadaver heads.


      The diameter of the medial palpebral artery was found to be 1.50±0.28 mm on the right, and 0.70±0.12 mm on the left. The diameter of the lateral palpebral artery was measured as 0.62±0.10 mm on the right, and 0.59±0.12 mm on the left. The medial palpebral arteries travelling in the medial part of the eyelids usually arose as separate branches for the upper and lower lids, as superior and inferior medial palpebrals. In all cases, four arterial arcades, the marginal, peripheral, superficial orbital, and the deep orbital arcades, were revealed in the upper palpebra. These arterial arcades gave off small perforating branches. The perforating branches were identified on both sides of the tarsal plate and the orbicularis muscle. In four cases (11%) visible arterial variation was found near the inferolateral end of the levator palpebrae.
      Although many differences in the arterial features of the eyelid have been noted, there may not be a significant difference in the basic vasculature of the palpebra among races. A better understanding of the palpebral vascularity should allow modification of reconstructive techniques and reduce postoperative complications after eyelid surgery.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Persichetti P.
        • Lella F.D.
        • Delfino S.
        • et al.
        Adipose compartments of the upper eyelid: anatomy applied to blepharoplasty.
        Plast Reconstr Surg. 2004; 113: 373-378
        • Codner M.A.
        Reconstruction of the eyelids and orbit.
        in: Achauer B. Plastic surgery: indications, and outcomes. vol. 3. Mosby, St. Louis2000: 1425-1454
        • Muzaffar A.R.
        • Mendelson B.C.
        • Adams Jr., W.P.
        Surgical anatomy of the ligamentous attachments of the lower lid and lateral canthus.
        Plast Reconstr Surg. 2002; 110: 873-911
        • Hayreh S.S.
        The ophthalmic artery. III. Branches.
        Br J Ophthalmol. 1962; 46: 212-246
        • Kim B.G.
        • Youn D.
        • Yoon E.S.
        • et al.
        Unexpected bleeding caused by arterial variation inferolateral to levator palpebrae.
        Aesthetic Plast Surg. 2003; 27: 123-125
        • Boo-Chai K.
        Preoperative bleeding in the pre-tarsal (post-aponeurotic) space in oriental blepharoplasty.
        Br J Plast Surg. 2001; 54: 370
        • Kawai K.
        • Imanishi N.
        • Nakajima H.
        • et al.
        Arterial anatomical features of the upper palpebra.
        Plast Reconstr Surg. 2004; 113: 479-484
        • Uchinuma E.
        • Sakurai H.
        • Shioya N.
        Anterofrontal superficial temporal artery island flap for full-thickness eyelid reconstruction.
        Ann Plast Surg. 1989; 23: 433-436
        • Harma M.
        • Asko-Seljavaara S.
        Temporal artery island flap in reconstruction of the eyelid.
        Scand J Plast Reconstr Surg Hand Surg. 1995; 29: 239-244
        • Tei T.M.
        • Larsen J.
        Use of the subcutaneously based nasolabial flap in lower eyelid reconstruction.
        Br J Plast Surg. 2003; 56: 420-423
        • Koshima I.
        • Urushibara K.
        • Okuyama H.
        • et al.
        Ear helix flap for reconstruction of total loss of the upper eyelid.
        Br J Plast Surg. 1999; 52: 314-316
        • Krastinova D.
        • Franchi G.
        • Kelly M.B.
        • et al.
        Rehabilitation of the paralysed or lax eyelid using a graft of conchal cartilage.
        Br J Plast Surg. 2002; 55: 12-19
        • Siegel R.J.
        Palatal grafts for eyelid reconstruction.
        Plast Reconstr Surg. 1985; 76: 411-414
        • Nakajima T.
        • Yoshimura Y.
        One-stage reconstruction of full thickness lower eyelid using subcutaneous pedicle flap lined by a palatal mucosal graft.
        Br J Plast Surg. 1996; 49: 183-186
        • Furnas D.W.
        • Furnas H.
        Angular artery flap for total reconstruction of the lower lid.
        Ann Plast Surg. 1983; 10: 322-325
        • Porfiris E.
        • Chrisopoulus A.
        • Sandris P.
        • et al.
        Upper eyelid orbicularis flap with tarsoconjuctival island for reconstruction of full-thickness lower lid defects.
        Plast Reconstr Surg. 1999; 103: 186-191
        • DiFrancesco L.M.
        • Codner M.A.
        • McCord C.D.
        Upper eyelid reconstruction.
        Plast Reconstr Surg. 2004; 114: 98e-107e
        • Khan J.A.
        • Garden V.S.
        Combined flap repair of moderate lower eyelid defects.
        Ophthal Plast Reconstr Surg. 2002; 18: 202-204
        • Borman H.
        • Ozcan G.
        Modified adjustable technique to anchor the levator muscle to the flap used in total upper eyelid reconstruction.
        Br J Plast Surg. 1998; 51: 566-568
        • Uchinuma E.
        • Tsujino I.
        • Shioya N.
        Eyelid reconstruction using a vascularized composite flap.
        Aesthetic Plast Surg. 1998; 22: 126-129
        • Han S.
        • Ock J.J.
        Treatment of cicatricial lagophthalmos: very small orbicularis oculi muscle pedicled skin flap.
        Br J Plast Surg. 2001; 54: 675-679
        • Hwang K.
        • Kim B.G.
        • Kim Y.J.
        • et al.
        Lateral septoaponeurotic artery: source of bleeding in blepharoplasty performed in Asians.
        Ann Plast Surg. 2003; 50: 156-159
        • Tucker S.M.
        • Linberg J.V.
        Vascular anatomy of the eyelids.
        Ophthalmology. 1994; 101: 1118-1121
        • Wolfort F.G.
        • Vaughan T.E.
        • Wolfort S.F.
        • et al.
        Retrobulbar hematoma and blepharoplasty.
        Plast Reconstr Surg. 1999; 104: 2154-2162
        • Sutcliffe T.
        • Baylis H.I.
        • Fett D.
        Bleeding in cosmetic blepharoplasty: an anatomical approach.
        Ophthal Plast Reconstr Surg. 1985; 1: 107-113
        • Yeatts R.P.
        • Newsom R.W.
        • Matthews B.L.
        Doppler-assisted vascular pedicle flaps in eyelid and periorbital reconstruction.
        Arch Ophthalmol. 1996; 114: 1149-1152