Superficial Temporal Artery Ligation

For several years, I had hated my very prominent superficial temporal artery on the right side. A combination of age (38) and heavy cardio for most of my adult life resulted in very low body fat and this was especially evident in the temple region. With no fat or collagen in that area, this pulsating anaconda going up my face was very noticeable. If I worked out, got hot, was tired, or simply just leaned over, it would swell and pulsate dramatically. Even at total rest, it didn’t go away and could be seen pulsating from my temple hairline all the up my forehead.
I researched different solutions and there is really only one treatment—ligating the artery. While I found a vascular surgeon who had no problems doing the procedure, I really wanted a plastic surgeon due to the potential of scarring. That’s what led me to Dr. Barry Eppley.
I read Dr. Eppley’s blog posts on this procedure and looked at before and after photos. All of the patients were young men like me who had very prominent temporal arteries, some of them on both sides. I picked Dr. Eppley due to his experience with this procedure and great reviews.
After making an appointment, I met with Dr. Eppley via Zoom and we discussed the procedure. He answered all of my questions including concerns about hair loss, safety, and scarring. Contrary to popular belief, hair loss is not caused by decreased blood flow and given how vascular the scalp is, the ligation of this arterial branch has no adverse effect whatsoever. As for scarring, Dr. Eppley explained that he uses tiny incisions carefully placed in natural creases and that no one had ever requested a scar revision.
I booked my procedure date and flew to Indiana for a pre-op meeting with Dr. Eppley the morning I arrived. He examined the artery and went over a few instructions. I was all set for the procedure the next day.
After arriving at the surgical center, Dr. Eppley marked the artery and I went back to the operating room. The procedure was done under local anesthesia and was not painful at all. The most I felt was some pressure. Dr. Eppley made 4 small incisions, 2 in the hairline, 1 on the temple, and 1 on the very upper forehead. Through these incisions, he tied off the artery at various points and closed the incisions with dissolvable sutures. The whole procedure took about 45 minutes. I got up off the table, drive to the airport, and flew home.
The first night, the incisions ached mildly and that was relieved with Tylenol. The incisions in the hair closer to the ear stayed sore for about 3 weeks and I couldn’t sleep on that side. It wasn’t a constant pain, only when pressure was applied. The most important thing is that the artery was gone. No more pulsating, no more wiggly worm up the side of my face. It’s still under the skin, but with no blood flow, it cannot be seen.
I am now almost 8 weeks out and very pleased. No hair loss has occurred, there has been no adverse effects, and the incisions are healing nicely. They did stay swollen like mosquito bites for several weeks, but that has almost completely resolved. The incisions on the visible part of the skin are still a little red, but getting better by the day.
I would definitely recommend this procedure and Dr. Eppley if you have unsightly temporal arteries. The procedure is safe, effective, and will definitely boost your confidence if prominent temporal arteries are bothering you.