The facial vein, also referred to as the anterior facial vein, is a paired vessel and the main vein of the face. The facial veins stem from the angular veins on each side of the root of the nose. Some sources claim that the angular vein, which arises from the confluence of the supratrochlear and supraorbital veins, is only an initial segment of the facial vein.

The facial vein courses through the face and then through the neck, thus being divided into the facial and cervical parts. From the root of the nose, the facial vein descends obliquely downwards towards the mandible, receiving many tributaries from the superficial structures of the face. It then emerges in the neck by crossing the body of the mandible. It collects several tributaries in the neck, after which it unites with the anterior branch of the retromandibular vein to form the common facial vein. Finally, the common facial vein conveys the blood from the facial vein into the internal jugular vein.

Origin and course
Facial vein (Vena facialis); Image: Yousun Koh
Facial vein (Vena facialis)
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The facial vein arises as a continuation of the angular vein, just below the level of the inferior margin of the orbit. Near its origin point, the facial vein receives the supratrochlear and supraorbital veins via the angular vein. It then passes obliquely downwards on the lateral side of the nose, receiving the external nasal and inferior palpebral veins.

The facial vein then continues obliquely across the face, passing posterior to the zygomaticus major, risorius and levator labii superioris muscle. Within this area of the face, the facial vein receives the superior and inferior labial veins, as well as the deep facial vein via which it communicates with the pterygoid venous plexus of the infratemporal fossa.

At the lower part of the face, the facial vein descends along the anterior surface of the masseter muscle, reaching the body of mandible. It then curves posteriorly around the body of mandible and enters the neck. In this part of its course, the facial vein passes deep to the platysma and cervical fascia, and superficial to the submandibular gland, digastric muscle and stylohyoid muscle. The cervical portion of the facial vein receives the submental, tonsillar, external palatine, lingual, submandibular, pharyngeal and superior thyroid veins.

Drainage

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Below the mandibular angle, the facial vein pierces the deep investing cervical fascia and unites with the anterior branch of the retromandibular vein to form the common facial vein. The common facial vein descends superficial to the loop of the lingual artery, the hypoglossal nerve and external and internal carotid arteries, and goes on to drain into the internal jugular vein, roughly at the level of the hyoid bone. Occasionally, the common facial vein may cross over the sternocleidomastoid muscle and drain into the external or anterior jugular vein.

Clinical significance
Thrombosis of the cavernous sinus
The facial vein communicates with the cavernous sinus via the angular vein. This is a fact of great clinical significance, because any infection of the region of the face drained by the facial vein can spread to the cavernous sinus, resulting in a serious condition called thrombosis of the cavernous sinus. Infection of the facial vein that spreads to the dural venous sinuses may occur as a result of a nasal abscess or after squeezing a large pustule (pimple) on the side of the nose and upper lip. This is why the area from the corners of the mouth to the bridge of the nose is deemed the danger triangle of the face.

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