Objectives: Temporal Fossa Revolumization is important in facial rejuvenation yet under appreciated.
Introduction: Temporal Fossa Revolumization is recognized as a hallmark of youth and health, given that the fullness of the temporal area signifies vigor. However, with the progression of aging, the temporal fossa often loses its convex shape, transforming into a concave or depressed area. This change makes the temporal crest and the zygomatic arch more prominent, imparting a skeletal appearance to the face. Particularly in individuals with a slender build, this can lead to a noticeable skeletonization of the upper face.
Materials / method: In the academic literature, three potential injection planes within the temporal fossa have been identified for safe intervention: subcutaneous; deep to the temporo-parietal fascia; and beneath the temporalis muscle, directly on the periosteum2. Although there are no regions deemed absolutely safe, certain planes, such as the interfascial plane—situated between the superficial and deep temporal fascia and comprised of loose areolar tissue and fat pad—are considered ideal due to their avascularity.
Results: Nevertheless, care must be taken to prevent injury to the sentinel vein or the frontal branch of the facial nerve, which are located within the temporal fascia on the roof of the injection plane.
The technique of bilevel revolumization involves injections at the subcutaneous level or within the interfascial layer using a cannula, in combination with supra-periosteal injections performed perpendicularly with a sharp needle.
Conclusion: Fundamental safety measures include employing retrograde injections, maintaining constant movement, applying low pressure, and ensuring slow injection speeds, all while vigilantly monitoring the patient's responses to minimize discomfort. Despite its critical importance in facial revolumization, the temporal region frequently remains under appreciated.
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