The skin of the face varies in character at different parts. In the orbital region it is very thin, and possesses but little subcutaneous tissue ; in the cheeks it is thicker, and possesses a single thick layer of subcutaneous tissue, which extends down to the periosteum of the bone, and contains much fatty tissue. A special pad of fat which lies between the anterior border of the masseter and outer aspect of the buccinator, and which is separated from the rest of the fatty tissue of the cheek by a layer of fascia from the parotid capsule, is known as the sucking or buccal pad of Bichat. It is not much affected in general emaciation, and accordingly becomes very prominent, especially in emaciated children. In the lips and chin the skin is thick, and the subcutaneous tissue is largely occupied by muscular tissue. The skin of the face is richly supplied with fat and sweat glands, and is a common seat of acne.
Superficial abscesses are generally small, while subcutaneous effusions can spread readily in the lax tissues of the eyelids and cheeks, but meet with resistance in the chin. The swelling of the lower eyelid, which occurs in some renal conditions, is well known. Cancrum oris, a rapidly progressing gangrene seen occasionally in neglected children, begins on the inside of the cheek, and rapidly spreads to the outside and peripherally, causing complete destruction of the parts. Malignant pustule, caused by anthrax, frequently affects the face. Rodent ulcer frequently attacks the parts above a line drawn from the nostril to the lobe of the ear, while lupus affects the parts below this line. The face is richly supplied with blood by the facial artery, which, arising from the external carotid, crosses the lower jaw along the anterior border of the masseter, the vein lying some distance posterior. It runs up toward the angle of the mouth, and then to the inner canthus of the eye, its course being very tortuous, and many branches being given off, which anastomose with (a) those of the opposite side, (b) branches from the temporal and internal maxillary, and (c) ophthalmic of the internal carotid. Bleeding from wounds of the face is accordingly free, it being frequently necessary to secure both ends of a divided vessel. Naevi, both capillary and cavernous, not infrequently affect the face, especially the lips. The facial vein is of importance, as it has no valves, tends to remain patent on section, and because it communicates with the internal jugular in the neck, and with the cavernous sinus, both (a) through the angular vein, which communicates with the superior ophthalmic vein, which opens into the sinus, and (b) through the deep facial vein, which runs to the pterygoid plexus, which is connected with the cavernous sinus by little veins traversing the foramen ovale. Thus, septic affections of the face may readily give rise to great septic absorption and sinus thrombosis. The lymphatics of the inner portions of the face drain chiefly to the submaxillary and superficial cervical glands, while the outer portions drain to the parotid region.
Congenital cavernous lymphangiomata are occasionally met with in the face.