The arterial supply to the face is primarily provided by branches of the external carotid artery, though there is also some limited supply from a branch of the internal carotid artery.

Facial artery

The facial artery is the major vessel supplying the face, and it branches from the anterior surface of the external carotid artery. The facial artery passes up through the deep structures of the neck, and appears at the lower border of the mandible after passing posterior to the submandibular gland. Curving around the inferior border of the mandible just anterior to the masseter, where its pulse can be felt, the facial artery then enters the face. Then, the facial artery, runs upward and medially in a tortuous course. It passes along the side of the nose and terminates as the angular artery at the medial corner of the eye.

Along its path, the facial artery is deep to the platysma, risorius, zygomaticus major and zygomaticus minor, superficial to the buccinator and levator anguli oris, and may pass superficially to or through the levator labii superioris.

Branches of the facial artery include such vessels as the superior and inferior labial branches and the lateral nasal branch.

The labial branches arise near the corner of the mouth:

The inferior labial branch - supplies the lower lip.
The superior labial branch - supplies the upper lip and also provides a branch to the nasal septum.

Near the midline, the superior and inferior labial branches anastomose with their companion arteries from the opposite side of the face. This provides an important connection between the facial arteries and the external carotid arteries of opposite sides.

The lateral nasal branch is a small branch arising from the facial artery, as it passes along the side of the nose. It supplies the lateral surface and the dorsum of the nose.

Transverse facial artery

The transverse facial artery arises from the superficial temporal artery within the substance of the parotid gland, passes through the gland, and crosses the face in a transverse direction. Lying on the superficial surface of the masseter muscle, it passes between the zygomatic arch and the parotid duct.

Branches of the maxillary artery

The maxillary artery is the largest of the two terminal branches of the external carotid artery. It gives off several small branches that contribute to the arterial supply to the face, and these are:

Infraorbital artery - enters the face through the infra-orbital foramen and supplies the lower eyelid, upper lip, and the area between these structures;
Buccal artery - enters the face on the superficial surface of the buccinator muscle and supplies structures in this area;
Mental artery - enters the face through the mental foramen and supplies the chin.

Branches of the ophthalmic artery

Three small arteries from the internal carotid artery also contribute to the arterial supply of the face. These vessels arise from the ophthalmic artery, a branch of the internal carotid artery, after the ophthalmic artery enters the orbit:

Zygomaticofacial and zygomaticotemporal arteries - come from the lacrimal branch of the ophthalmic artery, enter the face through the zygomaticofacial and zygomaticotemporal foramina, and supply the area of the face over the zygomatic bone.
Dorsal nasal artery - a terminal branch of the ophthalmic artery, exits the orbit in the medial corner, and supplies the dorsum of the nose

Other branches of the ophthalmic artery - the supraorbital and supratrochlear arteries - supply the anterior scalp.

Venous drainage

Most of the venous blood from the tissue of the face drain back to the internal jugular vein, though some important connections from the face result in venous return through a clinically relevant intracranial pathway involving the cavernous sinus.

Facial vein

The facial vein is the major vein draining the face. Its point of origin is near the medial corner of the orbit as the supratrochlear and supraorbital veins come together to form the angular vein. This vein becomes the facial vein as it proceeds inferiorly and assumes a position just posterior to the facial artery. The facial vein descends across the face next to the facial artery, until it reaches the inferior border of the mandible. Here, the artery and vein part company and the facial vein passes superficial to the submandibular gland to enter the internal jugular vein.

Throughout its course, the facial vein receives tributaries from veins draining the eyelids, external nose, lips, cheek, and chin that accompany the various branches of the facial artery.

Transverse facial vein

The transverse facial vein is a small vein that accompanies the transverse facial artery in its journey across the face. It empties into the superficial temporal vein within the substance of the parotid gland.

Intracranial venous connections

As the facial vein crosses the face, it has numerous connections with venous channels passing into deeper regions of the head:

Near the medial corner of the orbit, the facial vein communicates with the ophthalmic veins.
In the area of the cheek, it communicates with veins passing into the infraorbital foramen.
It also communicates with veins passing into deeper regions of the face (i.e., the deep facial vein, which is connected with the pterygoid venous plexus).

All these venous channels have interconnections with the intracranial cavernous sinus through emissary veins that connect intracranial veins with extracranial veins. There are no valves in the facial vein or any other venous channels in the head, so blood can move in any direction. Because of the interconnections between the veins, infections of the face, primarily above the mouth (i.e., the “danger area”) should be handled with great care to prevent the dissemination of infectious material in an intracranial direction.

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Blood supply of the face