Temple fillers are becoming increasingly popular across the globe and has very powerful clinical outcomes. However, thorough knowledge about the anatomy of important vessels and tissue planes is essential for injectors. Here we look at temple anatomy, injection techniques and their associated risks.
Forehead & glabellar anatomy consists: skin, superficial fat pads (2 lateral and 1 central separated by fibrous septae) – vasculature, frontalis (SMAS), deep fat pads – loose areolar tissue – Galea and periosteum.
Temporal fossa has 2 compartments: superior and inferior (1cm above zygoma). Borders of temporal fossa are:
- Anterior – lateral orbital rim and zygomatic bone
- Inferior – zygomatic arch
- Superior – temporal crest
We inject Temples because of: aging process, temporal volume loss, visible temporal margins and visible vasculature. Youthful temples are slightly convex, have smooth transition from forehead to cheek and subtle brow/lid lift.
Injection techniques for this treatment are:
- Subdermal – layer 2 – using a cannula – retrograde fanning technique
- Loose areolar tissue – layer 4 – using a cannula
- Supraperiosteal bolus – layer 9 – using a needle (25G)
Hematoma, intracranial penetration (if using needle) and vascular compromise are the most common complications of these injections. With all being said, temporal rejuvenation should be part of your practice but only experienced injectors must do it.