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Aesthetics Practice Today

Temporal Fossa Augmentation

Published July 15, 2014 3:46 PM by Mina Grasso
With the increasing popularity of tissue fillers, patients are looking more youthful in the mid and lower face. When looking at patients with volume augmentation of the mid and lower face, there can be a disruption in the frame of the face where the temporal fossa are hollow and overlooked. The temporal fossa is located just above the cheekbones behind the lateral orbital rim.   

As we age, the temporal bone becomes more concave. The temporal fat pad and overlying temporal muscle size diminishes. The youthful convex shape of the temples transforms to a more concave and hollow contour. This area appears more skeleton-like when the bony margins of the zygomatic arch appear more prominent. This skeleton-like appearance is associated with aging or poor health.

Hairstyles have been altered to camouflage the temporal hollows. Augmentation of the temporal fossa can improve the facial contour; create a healthier, more balanced, natural appearance. 

Soft tissue augmentation can be accomplished with autologous fat transfer. However, most patients seeking this treatment are usually limited in fat stores. Athletic women who maintain low body fat are the ones that most commonly request this procedure in our clinic. Various tissue fillers such as Radiesse (calcium hydroxylapatite) and hyaluronic acids which include: Restylane, Perlane, Juvederm have well-established benefits and have approximately one year duration of action. These fillers can provide an immediate improvement of the hollowed temples. Sculptra (poly-l-lactic acid), a bio-stimulator of collagen. It requires multiple treatments but provides long lasting results of up to two years. 

Advanced training on injection techniques is required for augmenting the temporal fossa. Various techniques are utilized for soft tissue augmentation using the various products. Traditional use of needles to deliver the product using a depot, fanning or cross-hatching techniques are popular. Risks include hematoma, vessel occlusion or emboli, nerve damage, numbness and infection. Some prefer to use a blunt tip cannula to avoid some of these issues. When using a blunt tip cannula, caution is needed to avoid linear tracks that can be visible when product is placed too superficially. 

When examining a patient for facial rejuvenation, evaluate the temporal area for hollowing. Safe and effective treatment is now available for this area that has often been overlooked.

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    Occupation: Physician Assistant/Nurse Practitioner
    Setting: Miami & Upland, Calif.
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