How do I fix a hollow temple as it makes me look tired and older (photo)?

Doctor's Answers 2

Hi, it is evident that there is volume and fat loss over your temples and extending to the forehead as well. This are normal signs of aging.

It is aesthetically significant because it breaks the smooth silhouette of the head. To some, it is desirable to have a smooth curvy silhouette of the head from the forehead to temples to cheekbones to jawbone and to the chin (forming a heart-shaped outline) for the best aesthetic outcome.

Treatment will be using fillers and my preference is using a cannula (blunt needle) to spread the filler like a thin carpet under the skin and superficial temporal fascia. Experience and technical skills are very important here due to the challenging anatomy and superficial plane (easily leading to lumpiness in poor techniques or poor experience).

My filler of choice is the collagen-stimulating filler Ellanse for ladies who want that extra collagen boost, or Teosyal RHA3/4 for younger ladies.

This is a interesting question as most people are not aware of the hollowness in the temple area and how it affects their looks . This could also be due to the fact that this is not entirely due to aging and some have it since young and think that it cannot be treated.

The other possible reason for this especially in females is that their hair covers this area quite well. It is only when they start pulling their hair back or when the hollowing becomes worse and associated also with facial volume loss in the anterior and lateral cheeks that they noticed how aged or tired they look.

Loss of volume in all these areas pulls the face down and creates a tired looking face. Going back to the temple hollow , the easiest way would be to replace the volume loss through the use of a filler. Most Doctors would prefer to use a hyaluronic acid ( HA) Filler or a Calcium Hydroxyapatite Filler like Radiesse.

There are 2 ways to administer the Filler , either

1. injection of a bolus dose deep down to the bone with a sharp needle or

2. the use of a cannula to distribute the filler in a intermediate plane.

Both methods have their pros and cons and different Doctors would have their own preference . The choice of an appropriate filler is important as different filler gels are suited for deep or intermediate planes of injection.

One of the common issues associated with deep injection is the occurrence of headaches which is temporary. Also deep injections in theory would also require more volume of the filler to be used which may make it more costly .

Use of a cannula to inject in this area is technically more challenging so the doctor needs to be more experienced. If injected too superficially surface irregularities becomes a problem .

Hopefully you can have the treatment done and look more refreshed.

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