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Fillers
Fillers
The goal of filler treatments in the temples is to achieve a gentle straight or minimally concave contour, helping to position the lateral eyebrow more anteriorly, creating a continuous contour with the zygomatic arch. Some of the HAs that are used in the temples include Juvederm Voluma, Juvederm Volift, Juvederm Ultra Plus, Restylane Volyme, Restylane Defyne, and Belotero Intense. When utilizing a needle, slow bolus injections are commonly employed in the temples. Use of the tower technique with injections at different depths could potentially lead to intravascular injection as one withdraws the needle to inject more superficially.
The first injection point is placed at the intersection of two lines that are drawn 1 cm above the lateral orbital rim and 1 cm lateral to the temporal suture line. Further adjacent injection points may be used as clinically indicated.47 Application of pressure near the temporal hairline will prevent the flow of product into the scalp and will instead direct the product inferiorly to fill the temporal hollow. There are different schools of thought with respect to ideal injection depth. Some injectors promote deep injection such that the needle is deep to important neurovascular structures, while others suggest that superficial injections will minimize risks. One disadvantage of deep injections is that larger volumes may be required to achieve results comparable to those obtained with more superficial injections. However, the latter technique may lead to
irregular surface contour, creating a โcobblestoneโ appearance due to superficial product placement.
Microcannulas may also be used in the temporal region. Entry at the posterior margin of the temporal fossa near the hairline29 or at the zygomatic arch are two options for cannula insertion.
Precautions, pearls, and pitfalls Precautions should be taken to avoid injury to the superficial temporal artery and the frontal branch of the facial nerve which are located close together in the subdermal fat.
Prior to injecting, palpate and avoid the temporal artery and slowly aspirate on the needle plunger to minimize the risk of an intravascular placement; keep in mind that a negative aspiration test does not guarantee nonintravascular placement.