The anatomy of the palpebral branch of the infraorbital artery relating to midface lift

The aim of this study was to elucidate a branch of the infraorbital artery (IOA) crossing the arcus marginalis into the orbit that might be vulnerable during a procedure of midface lift or fat sliding or a transposition in lower blepharoplasty.Eleven orbits of 6 Korean cadavers were dissected after injecting red latex into the external carotid artery. The IOA and nerve were identified. A branch of the IOA running upward was traced. In 28 cases of blow-out fracture, a branch of the IOA crossing the arcus marginalis into the orbit was identified, and the location was measured from each medial and lateral canthus.The palpebral branch of the IOA (PIOA) emerged from the infraorbital foramen and ran superior and lateral to the orbital septum. After passing through the orbital septum near the arcus marginalis, PIOA was distributed to the orbital fat. The palpebral branch of the IOA was identified in 21 (75.0%) of 28 fractured orbits. Twenty orbits had 1 PIOA, and 1 orbit had 2 PIOAs. The location of PIOA from the medial canthus (49.0%) was approximately half of the eye width in average. Most of the PIOAs (91%, 20 of 22 arteries found) were included in the range of 40% to 80% of the eye width from the medial canthus.Knowledge of the anatomic course of the PIOA crossing the arcus marginalis is conducive to cauterizing the vessels, as needed, in the subciliary or transconjunctival approach for lower blepharoplasty.