Managing alopecia after temple filler and the preventive role of ultrasound

Objetivos: To highlight delayed alopecia after temple hyaluronic acid filler injection as a potential manifestation of vascular compromise, and to emphasize the importance of early ultrasound assessment for prevention, prompt diagnosis, and timely management to reduce the risk of permanent hair follicle damage. Introducción: Temple augmentation is widely performed for facial rejuvenation and contour enhancement. However, the temple has complex vascular anatomy, making it a high-risk area for vascular complications. While skin necrosis is a well-recognized complication, alopecia following temple filler may present in a delayed manner. Hair loss may represent ischemic injury secondary to arterial compression, occlusion, or embolization affecting hair follicle perfusion. This case highlights delayed alopecia after temple filler injection and the importance of ultrasound after filler to screen vascular compromise. Materiales / método: A case of delayed alopecia following temple hyaluronic acid filler was retrospectively reviewed. Patient came with localized hair loss after the procedure and was managed promptly using vascular compromise management protocols, resulting in successful hair regrowth. At the time of the complication, ultrasound assessment had not yet been incorporated into routine practice. Following this experience, ultrasound-guided evaluation became routinely performed before and after temple filler injection to assess filler placement and vascular flow to early detect the possibility of vascular occlusion Resultados: The patient come with alopecia after temple filler without skin necrosis. Hair loss visible days after treatment, suggesting delayed ischemic injury to hair follicle. Following prompt management, hair regrowth occurred without permanent scarring alopecia. This case highlights that alopecia may occur after temporal filler, so integrating Ultrasound into daily screening tools after dermafiller is mandatory to prevent vascular event in the future Conclusión: Delayed alopecia following temporal filler injection is rare. However, because its presentation may be delayed and subtle, it can be frustrating for both the patient and the injector. Integrating ultrasound into daily dermal filler practice is therefore essential, not only to evaluate vascular flow and confirm filler placement planes, but also to help prevent delayed vascular-related complications through earlier detection and safer injection assessment