Variability in the anatomy of the supratrochlear artery (STA) carries implications for the use of a paramedian forehead flap in facial reconstruction. While prior reports have documented STA branching configurations and the vessel’s separation from the midline, the STA pedicle itself has received no systematic description. The present work set out to triangulate the STA pedicle against familiar anatomical landmarks and map a danger zone that could help surgeons construct viable tissue flaps. A total of 38 cadaveric donors underwent bilateral dissection of the upper facial territory. Values were captured for the distances spanning from the supraorbital neurovascular bundle, the orbital rim, and the medial canthus to the STA pedicle. Results were tabulated and evaluated with statistical methods. For each measurement, mean, range, and standard deviation were derived; comparison by side revealed no significant discrepancies (P > 0.05). Across all metrics collected from male and female donors alike, statistically significant sex differences were detected. By mapping a surgical danger zone specific to the STA pedicle in the context of a paramedian forehead flap, this investigation brings to light notable sex-based variations within that zone—differences that surgeons should heed to steer clear of pedicle breach, bolster operative success, and achieve the greatest possible flap length and mobility.
