Possible to Have Smooth Fat Transfer to Temples with Thin Caucasian Skin?

There are a few techniques in regards to method of injection and depth of injection which can result in a smooth contour despite thin skin.

Yes, fat grafting can improve this area but it is a difficult and challenging problem.  Even if the fat grafts are placed evenly, there is no guarantee of symmetrical and even "take" of the fat.  If some fat survives in one area but dies and resorbs in another area, you may get some contour irregularity.  Expecting an absolutely perfect result with fat grafting is unrealistic.  That is one of the problems with fat grafting. There is some inherent unpredictability. If you are paying for an elective cosmetic procedure, you expect predictable results. While fat grafting techniques have improve significantly, "a very smooth result" cannot be achieved 100% of the time.

Yes, you absolutely can get a smooth, natural-appearing result from fat grafting to the temples.  If your temples are deeply hollow, be prepared for the fact that it may require two or three fat grafting procedures to fill this area to the 'fullness endpoint' that you have in mind.  Deeply hollow temples present a challenge for fat grafting, as there is not much space in which to graft fatty tissue.  There's just skin, a thin layer of fascia (a sheet of connective tissue made of collagen), and a thin muscle layer (the temporalis muscle) - and then you're at the temporal bone.  I counsel patients that the goal of the initial procedure is to provide a soft tissue 'scaffolding' into which additional fat can be grafted at a later date, and I generally wait a minimum of three months between procedures.  Patients with mild to moderate temporal hollowness often get an adequate improvement from a single fat grafting procedure.

Successful temple-area fat grafting requires meticulous technique and significant experience with fat grafting in general.  In terms of the rejuvenating effect, it is one of my favorite areas to treat because full temples dramatically convey youthfulness and vitality, but no one is going to ever figure out exactly what is different about a patient who has had this procedure done.  No one will ever say to you "Oh you had your temples fat grafted, didn't you".  They'll just think you look healthy, rested and more youthful.

There is a temporary but relatively long-lasting alternative to fat grafting of the temples, if you are not sure you are ready for a surgical procedure, or if you prefer a temporary correction to make sure that you are comfortable with the appearance of fuller temples.  Juvederm (a hyaluronic acid filler) can be diluted and injected into the temples to produce a fuller appearance; in many patients the effect will last 1-2 years, which is significantly longer than the average duration of Juvederm effect in the lips and nasolabial folds.

Using good technique and a special blunt canula for injection , one can achieve a good smooth results.

If the skin is really very very thinThen one can use alternative methods to fill hollow areas.

 IMHO, you can't use the terms "smooth" and "fat transfer" in the same sentence.  Fat transfe is still injected in clumps using rather large needles and has the problem of unrelaibity as some will absorb.  Sculptra is the best solution for temple indentations, IMHO.  Performed as an office treatment, Sculptra will build up your body's own collagen and lasts up to 2 years.

When done properly, fat grafting can reshape the face in a very natural way. We often fill the "temporal hollow" and have had excellent results. Equally important is how the fat is harvested for the fat grafting. If great care is not taken in processing the harvested fat, it can compromise the longevity of the grafted fat. I recommend you find an experienced plastic surgeon to perform your facial reshaping. Good luck.