What are the risks of temple augmentation using an implant or bone paste/hydroxyapatite? Is a large incision made coronal or small in the hairline?
What Could Be the Risks in Temple Augmentation?
Doctor Answers 2
Temple augmentation using your own fat
Temporal wasting (the formation of a concave area in the temple regions) is a natural part of the aging process. It is caused by the normal shrinking of facial fat as one ages. There are a number of possible surgical procedures that are available to address this. The most agressive is the use of implants that can be made of a variety of materials (silicone, medpor...). These usually require a larger scalp incision with the risk of hair loss along the incision line. Implants can shift position, become infected etc.
There are also a number of injectable materials that can be used without making an incision such as perlane, sculptra. I prefer injecting fat harvested at liposuction elsewhere on the body. After a short period of time the fat does not move and has almost no risk of infection. The caveats are that the patient has to have some fat elsewhere and the highest fat survival rate with the most even surface contour is when the fat is injected deep to the fascial covering of the temple muscles. That is why I usually do this step at the time of a facelift and offer it to all facelift patients who are good candidates for it. Since these patients usually get a vertical incision in the hair bearing temple scalp the visualization for injection is more than adequate. I am submitting the photo of such a patient to the realself website.
Risks of temporal augmentation
Generally if this is unilateral it can be achieved through a hemicoronal incision.
There are many potential risks such as infection, hematoma, wound breakdown, hypertrophic scar formation, cicatricial alopecia, partial/complete injury to the temporal branch of the facial nerve with frontalis paresis/paralysis or brow ptosis, implant exposure, extrusion, erosion, migration, resorption, need for secondary revisionary procedures as well as inability to guarantee a specific functional and/or cosmetic result.