Digital Compression of the Origin of the Nasal Branch of the Ophthalmic Artery During Filler Augmentation: A Review of the Anatomical Literature and an Analysis of Plastinated Specimens

Abstract

The aim of this study was to determine the exact site of digital compression on the origin of the nasal branch of the ophthalmic artery during filler augmentation, by conducting a review of anatomical literature and examining plastinated specimens. According to 4 textbooks (Gray’s Anatomy, Whitnall’s Anatomy on the Human Orbit, Wolff’s Anatomy, and Duke-Elder’s System of Ophthalmology), the dorsal nasal artery leaves the orbit by piercing the orbital septum between the trochlea and the medial palpebral ligament and anastomoses with the angular part of the facial artery. In plastinated arterial specimens, the ophthalmic artery exits the orbit and divides into the supratrochlear artery and the dorsal nasal artery at the upper border of the lacrimal fossa. The dorsal nasal artery then anastomoses with the angular part of the facial artery. Branches of the dorsal nasal artery anastomose with their counterparts on the opposite side. During filler augmentation of the nose, bilateral digital compression is applied to the origins of the nasal branches of the ophthalmic artery, specifically at the point where the ophthalmic artery pierces the orbital septum. Applying compression just above the medial palpebral ligament against the bone, directly above the lacrimal sac, using the index finger and thumb can help prevent the migration of injected droplets to the ophthalmic artery. This straightforward maneuver, grounded in anatomical understanding, aims to prevent the migration of injected droplets to the ophthalmic artery.