The Hidden Dangers of Temple Filler

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Injectables and fillers can do wonders for treating sunken, hollow temples. Replacing lost volume in the area makes a dramatic difference in the upper third of the face and, unbeknownst to many, improves the appearance of the eyes.

However, there’s a lot to know about this rather tricky procedure. Niles, IL plastic surgeon Sam Speron, MD, says often, the temples are passed over because they are more difficult to inject with filler. Also, patients have a preconceived notion that they know what problems areas require filling and feel the temples are unnecessary. Nonetheless, one session is all it takes to see the difference, but proceeding with caution can evade adverse effects and potential problems.

If you and your doctor decide on temple filler, here’s everything to know before the needle makes contact with your skin to retain a natural look.

Understanding the Temples in Full Capacity

The temporal area isn’t a “glamour feature” like chiseled cheeks, pert lips, or a sharp-as-glass jawline. But the temples do provide function and support, impart a smooth, contoured appearance, and contribute to overall facial balance. They are also a pivotal element in achieving the highly desired heart-shaped face.

Like other areas of the face, the temples experience volume loss, resulting in a hollow, gaunt, or drawn look. The extent of hollowness overlying the temporal bone is roughly proportional to perceived age in the temples, says Los Angeles dermatologist Gene Rubinstein, MD.

Since the temples play an integral role in supporting the eyebrows, once volume begins to waste away, the sides of the brows can droop down, contributing to tired and hooded-looking eyes, explains New York dermatologist Julie Russak, MD. Conversely, reversing substantial volume loss in the temples provides balance and, as Bloomfield Hills, MI dermatologist Linda C. Honet, MD describes, “creates a foundation for the upper face and a youthful frame for the eyes.”

The Potential Risks

Temple filler can perk up the face, but like all cosmetic procedures, it comes with potential risks.

It’s a Vascular Area

The temple area is a vascular region with a vast blood supply. Some doctors call the temples “treacherous territory,” and while rare, there is a potential for vascular occlusions. Dr. Russak says the most considerable risk is not understanding the anatomy of the upper face and injecting filler into high-risk areas, like the temporal artery/vein or directly into the veins.

“Any injection site is a potential for occlusion,” warns Dr. Honet. “I use needle and cannula techniques, depending on the patient’s needs and anatomy—larger gauge cannulas carry somewhat less risk for vascular occlusion,” she adds. However, the injector’s education, training, experience, knowledge, and technique are more critical than any needle or cannula. While vascular occlusions are the greatest risk, others include bleeding, bruising, swelling, and nodules.

Distortion Can Happen

Excessive volume can cause protrusion of the upper part of the face, rendering it unbalanced and asymmetrical with an odd, distorted, almost alienish look. Not overfilling the space is key in preventing a bizarre look. “Balance and symmetry are important when treating the temples, and not taking these factors into consideration will cause the area to look done,” says Dr. Speron. But it’s not just excessive volume that can skew the face. Injecting the product into the wrong facial plane also looks unnatural.

Besides treating just the temples, the fat pad behind the brows, the upper eyes, and even the forehead often require filler to generate a natural-looking contour.

The Appropriate Fillers Can Influence the Result

Befitting fillers are paramount. While hyaluronic acid fillers give an immediate result, Dr. Rubinstein says biostimulator injectables, like Sculptra Aesthetic, gradually build the temples. Nonetheless, injecting fillers into the temples requires more structural integrity and contour retention, Dr. Honet says. One reason injectors prefer hyaluronic acid fillers over others is that they are dissolvable.

The Secret to a Good Result

The filler used and its placement are crucial. But even more imperative is who is doing the injecting. Dr. Russak stresses the importance of seeking treatment with an injector who understands the art of filler and restoring the natural appearance of the face.

“To reduce the risk for complications, seek care with a board-certified dermatologist or plastic surgeon who is well educated, well trained, extremely experienced and knowledgeable about injectables, and equipped to handle and treat an occlusion accordingly,” advises Dr. Honet. And that nugget of advice applies to all facial fillers and injectables, too.

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