"Not Above, Not Below: Right in the Middle!"-Novel Filler Technique for Temporal Augmentation and Rejuvenation.

Abstract

The temporal region is challenging to treat due to its thin skin, which has the propensity toward showing irregularities. The literature on temporal hollowing augmentation suggests placing the filler either into the subcutaneous space or within the temporalis muscle. However, these techniques have been based upon opinion rather than supporting anatomical and clinical data. We introduce a novel injection technique to avoid complications and achieve lasting results. This novel technique was confirmed with a cadaver model, in vivo model, and application to a human subject. The anatomical layers of the temporal region were highlighted: the skin, subcutaneous tissue, temporoparietal fascia (superficial temporal fascia), deep temporal fascia, superficial temporal fat pad, and temporalis muscle. Particular emphasis was placed on identifying the frontal branch of the superficial temporal artery to avoid vascular complications. We believe the potential space between the temporoparietal fascia and the deep temporalis fascia is the safest, most efficacious plane to inject the temporal region with a 27-gauge cannula. Our future goal is to recruit and present a larger series of patients receiving this injection.