04/07/2026
The Zygomaticofacial Foramen & Artery
How well do you know the vascular anatomy of the lateral midface?
The zygomaticofacial artery emerges through the zygomaticofacial foramen (ZFF) on the malar eminence before supplying the overlying skin and soft tissues of the cheek. It is typically a branch of the lacrimal artery (ophthalmic artery), although both its origin and branching pattern are variable.
One of the most important messages from the anatomical literature is that there is no single "normal" position for the zygomaticofacial foramen.
Key anatomical findings:
• The number of foramina may vary from 0 to 4. • Approximately 16% of individuals have no identifiable zygomaticofacial foramen. • The location varies between populations and ethnic groups. • When present, the foramen is usually located approximately 6 mm inferior to the inferior orbital rim, although this also demonstrates anatomical variation. • The zygomaticofacial artery is accompanied by the zygomaticofacial nerve as it exits the bone.
Although this is not considered one of the principal arteries associated with filler-induced blindness, understanding its location can help minimise bruising, bleeding and inadvertent vascular injury during lateral cheek and malar procedures.
As always, remember:
Treat every patient as anatomically unique—not as an illustration in a textbook.
References
Hwang SH, Jin S, Hwang K. Location of the zygomaticofacial foramen related to malar reduction. J Craniofac Surg. 2007;18(4):872–874.
Ferro A, Basyuni S, Brassett C, Santhanam V. Study of anatomical variations of the zygomaticofacial foramen and calculation of reliable reference points for operation. Br J Oral Maxillofac Surg. 2017.
Anatomical variations of the zygomaticofacial foramen and its related canal through the zygomatico-orbital and zygomaticotemporal foramina in dry human skulls. Anat Cell Biol. 2024.
Frequency and location of the zygomaticofacial foramen and its relevance to zygomatic implants. Anat Sci Int. 2020.
Fibiger G, et al. Zygomaticofacial foramen and its surgical anatomy in plastic and maxillofacial surgery: A systematic review and meta-analysis. Folia Morphologica. 2025/2026.
