The Supratrochlear Artery: Anatomy, Variations, and Clinical Relevance in Aesthetic Surgery

The supratrochlear artery (STA) is one of the terminal branches of the ophthalmic artery, coursing through the medial forehead and glabellar region to supply the central upper face. Although relatively small in caliber, it holds considerable clinical importance because of its anatomical variations and its communication with the ophthalmic circulation. These features make the STA especially relevant in both reconstructive procedures and aesthetic interventions. In this review, we examined the anatomy of the STA with a focus on its origin, branching characteristics, vessel diameter, depth variations, and anastomotic networks. We also explored its role in reconstructive surgery and aesthetic medicine. A systematic search was performed in the PubMed online database. Considerable variability was noted in its course and branching, including clinically significant intracranial-extracranial anastomoses with the angular, supraorbital, and dorsal nasal arteries. The literature included evidence from cadaveric dissections, Doppler ultrasonography, and angiographic studies, each of which contributed to a clearer picture of the vessel's patterns. From a surgical standpoint, case series emphasized the STA's central role in surgical reconstructions. On the other hand, aesthetic practice has highlighted the risks associated with its inadvertent cannulation during soft-tissue filler injections. Accidental intravascular injection into the STA or its anastomotic network has been linked to devastating outcomes, including vision loss. Overall, a detailed understanding of the STA's anatomy is essential for safe and effective practice. The combination of classical dissection data with modern imaging has improved preoperative planning and may reduce complications in minimally invasive procedures. This review brings together current knowledge on the STA, emphasizing its dual identity as both a valuable surgical vessel and a high-risk structure in aesthetic medicine.