Can I Have Other Facial Arteries Ligated With Temporal Artery Ligations?

Q: Dr. Eppley, I have the prominent arteries on my temples which I would like to have treated. In my case a y shape branch on the right hand side and a single vessel on the left. The pulsate very visibly even at rest. 

In addition to this I have a very visible pulse in general, especially in my neck and chest. On the right hand side of my face when it’s hot or I have exercised I can see my cheek pulsating and can feel this artery at all times running from my jaw, past my nose and up my forehead. My main concern with having the procedure done is that this artery pulsation would become worse and more visible. Have you seen this happen in any of your previous patients and if so is it safe to ligate this artery as well as the temporal arteries? 

A: While prominent temporal arteries can be safely and successfully ligated, their larger origins along the ascending pathway of the external carotid artery (ECA) are a different story. You are describing pulsations along the entire ECA which can not be treated. Whether such ECA pulsatile visibilities bode poorly for successful temporal artery ligations or would make these more proximal pulsations more visible I can not say since your aesthetic arterial situation is not one I have previously encountered.

Dr. Barry Eppley

World Renowned Plastic Surgeon