Anatomical case

Early trifurcation of the facial artery including a dedicated buccinator branch: anatomical and surgical implications

Ferdinando Paternostroverified— Università degli Studi di Firenze

Published on 9 August 2026Version 1

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Abstract

Variations in the branching pattern of the facial artery may affect the planning and outcome of reconstructive and aesthetic procedures in the midface. Here, we report a rare anatomical variant in which the facial artery trifurcates early into three distinct branches, including a novel buccinator branch. In January 2025, the right-sided facial artery of a 67-year-old male Caucasian cadaver, injected with colored acrylic resins, was dissected at the ICLO Teaching and Research Center (Verona, Italy). Following identification of the external carotid artery, the facial artery was traced via an oblique submandibular approach. Instead of the classical singular course, the facial artery formed a common trunk that, 2 cm distal to its origin, trifurcated within a 1 cm span along the inferior mandibular margin. The anteromedial branch followed the standard facial artery trajectory; the posterolateral (premasseteric) branch supplied the masseteric region; and the central (buccinator) branch penetrated the buccinator fascia, arborizing extensively within the muscle belly. This buccinator branch exhibited a markedly dense microvascular network not previously described. While the direct clinical impact of a single observation remains limited, awareness of such configurations may be relevant in selected surgical contexts, particularly in flap planning and in procedures involving the buccal region.

Original publication

This entry carries the summary of the work. The full text, with methods, results and figures, is at the publisher.

Fagni N, Paternostro F, Fiori GM, Livi L, Zinno G, Branca JJV, Bertelli E, Belviso I. Early trifurcation of the facial artery including a dedicated buccinator branch: anatomical and surgical implications. Case Reports in Plastic Surgery and Hand Surgery 2026;13(1):2664264. doi:10.1080/23320885.2026.2664264

https://doi.org/10.1080/23320885.2026.2664264
https://pubmed.ncbi.nlm.nih.gov/42131225/

Anatomical classification

Systems:: Cardiovascular system

Content provenance

Translation

Italian translation of «Early trifurcation of the facial artery including a dedicated buccinator branch: anatomical and surgical implications» by Fagni N, Paternostro F, Fiori GM, Livi L, Zinno G, Branca JJV, Bertelli E, Belviso I. Source: https://doi.org/10.1080/23320885.2026.2664264 Original work distributed under the CC BY 4.0 licence (https://creativecommons.org/licenses/by/4.0/deed.it). Translation by Redazione AIVA. Changes from the original: Sintesi del lavoro originale: abstract riprodotto integralmente come consentito dalla licenza CC BY 4.0, con traduzione italiana a fronte, citazione completa e rimando al testo integrale presso l’editore. Il testo completo non è riprodotto. This publication is not approved or endorsed by the authors of the original work.

Licence

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