Will Lower Facial Artery Ligations Reduce My Stinging Painful Arteries To My Upper Lip?

Q: Dr. Eppley, I am interested in lower facial artery ligation. I have been experiencing pulsating stinging, soar and painfully arteries just above my both sides of my lips, center area between nostril and lip. Feels like damaged area on artery of about (1cm) this area stings non stop as like it is damaged from some sort of trauma, because of this it pulls on the artery which feels very soar and like a tight string that runs up the side of my nose, up into the inside of each eye. I had a bad infection/disease in my nasal maxillaries that I seen a ENT for and was cleared out by penicillin antibiotics and cortisol steroids 1 year ago. But the stinging and damage in my artery has never stopped in this small area above my lips. I have seen two vascular surgeons and have received dye injected CT scans, but they have said the CT scans wont show the damage or inflammation on those arteries, and they said they do not remove or do procedures on those arteries. This is where I came across your article on the exact area of my problem. Is there a procedure of a four point ligation of this area or can I get a full removal of about a 1cm of artery in this area, as this is causing me massive problems with not being able to do any physical work not being able move around, as if I do it causes pulsating pain and stinging in that area of artery. You are the only Doctor that I have seen that has talked about this area. Could you please help.Thank you

A: In my limited experience with ligation of the facial artery for aesthetic purposes (visible pulsations) it has been a single area of treatment for either double ligations or resection on one side only. In other words for a very focused problem area that clearly could be identified with a treatment that is known to work. (bulging arterial resection = remove the dilated arterial section)

Your situation is very different in many regards. While it appears to clearly involve the facial artery branch there is bilateral involvement and has symptoms which are uncommon from any arteria problem that I have seen. It is uncertain with these symptoms as to whether arterial manipulations would be effective. In addiiton it is also bilateral and what should not be done is bilateral arterial treatment at the same time since this may have vascular compromise issues (necrosis) to the upper lip.

In short the question is not whether facial artery resection can be done but whether it would be effective for the unique problem that you have.

Dr. Barry Eppley

World-Renowned Plastic Surgeon