Anatomical safety in aesthetic medicine: how to inject accurately and avoid vascular risks

In aesthetic medicine, a poorly placed injection can be just 1 mm away from a serious vascular complication.
That’s why knowing vascular and bony anatomy with precision is not optional—it’s essential. In this article, we break down the most critical anatomical areas of the face, explaining how and where to inject to maximize both safety and results.

Key Anatomical Areas and Safety Recommendations

Forehead: the 2 cm line

Involved arteries: supraorbital and supratrochlear.
Risk: from 2 cm above the supraorbital rim, arteries run in the subcutaneous plane.
✔ Recommendation: always inject on bone in the upper forehead regions.

Temple: safe quadrant

Danger zones: branches of the superficial and deep temporal arteries.
✔ Safe zone: superomedial quadrant of 1 cm², directly over bone.
✘ Avoid: superficial planes, which carry a high risk of hematoma or embolism.

Zygomatic arch: handle with caution

Vascular risk: zygomaticofacial bundle and external carotid artery.
✔ Inject on bone; avoid passing through the vascular foramen.
➡ Tip: if you feel the foramen, stop and redirect.

Medial cheek (mid-cheek)

Danger zone: mid-limbal line (pupil + infraorbital groove).
✔ Inject lateral to the infraorbital foramen or use a cannula if medial.
✘ Never use a needle medial to this line without bony support.

Nasolabial fold

Arterial pathway: facial artery → angular artery.
✔ Safe technique: inject medial to the buccal-maxillary ligament, perpendicular to bone.
✘ Avoid following the facial artery laterally.

Lips: superficial or submucosal plane

Labial arteries: beneath the orbicularis muscle.
✔ Ideal plane: subcutaneous or submucosal, never intramuscular.
➡ For deeper placement: use a cannula.

Chin and marionette line

Risk: marginal mandibular branch and facial artery.
✔ Inject in the midline between the bellies of the mentalis or on bone lateral to the mental foramen.
✘ Never inject superficially near the submandibular groove.

Jaw angle

Hazards: external carotid artery, facial nerve, parotid gland.
✔ Safe technique: always on deep bone.
➡ Use a cannula if anatomy requires.

Tear trough and lower eyelid

✔ Inject beneath the orbicular ligament, in the subosseous plane.
✘ Avoid product overload in bags or festoons—it can worsen the result.
➡ Use a lateral cannula approach if you need to treat central areas.

Technical Keys for Safe Practice

Conclusion: Precision is Your Best Tool

Every facial treatment should be anatomically planned based on a deep understanding of bony, vascular, and muscular structures. Injecting safely not only protects the patient but also elevates your medical practice to the next level.

Would you like to perfect your injection technique with a solid anatomical foundation?
Discover our hands-on facial filler courses at CIME Academy and learn from experts how to turn every treatment into a safe, aesthetic, and clinically impeccable procedure.

Location: Calle Entenza Nº 144, 08929 Barcelona – Clínica CIME Barcelona
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E-mail: secretaria@cimeacademy.com