Purpose: Previous studies of the facial artery have shown significant anatomical variability in this region. The vascular anatomy of the region is considered unreliable in predicting the ideal pedicle. Preoperative imaging has been suggested as a means of improving preoperative awareness, with Doppler ultrasound as useful tools. Multi-detector row angiographic computed tomography (angio CT) is a significant improvement, providing noninvasive operator-independent details of the vascular anatomy. This tool was used to perform an $in$ $vivo$ anatomical study of the facial artery, demonstrating the usefulness of facial angio CT in planning the facial reconstruction. Methods: Eleven consecutive patients underwent facial angio CT of the facial vasculature with the anatomical details of the facial artery assessed. Results: Facial angio CT could demonstrate the size and course of the facial vasculature, particularly the facial artery. Conclusion: The vascular anatomy of the facial artery is highly variable, and thus there is a role for preoperative imaging. Facial angio CT can demonstrate cases where there is an aberrant or non-preferred anatomy, or select the method of a facial reconstruction.