title: Microanatomical Location of Hyaluronic Acid Gel Following Injection of the Temporal Hollows.
abstract: OBJECTIVE
  To examine the microanatomical location of hyaluronic acid gel injected within the temporal hollows of cadaver specimens.
  
  
  METHODS
  The temporal hollows were injected subcutaneously with hyaluronic acid gel in 6 fresh frozen human cadaver hemifaces. Temporal soft tissues were dissected to a preperiosteal plane and fixated in 95% alcohol. A soft tissue section extending from skin to temporal bone was obtained for each specimen. Histologic examination was performed using hematoxylin and eosin stain.
  
  
  RESULTS
  In 5 of 6 specimens, at least 95% of the hyaluronic acid was located within the subcutaneous fat. In 1 of 6 specimens, approximately 35% of the material was located within the subcutaneous fat and 60% was located within the superficial temporal fascia. Two specimens had 5% located within the temporalis muscle. In 1 specimen, hyaluronic acid was found to encompass a superficial muscular artery within the superficial temporal fascia.
  
  
  CONCLUSIONS
  This study elucidates the location of hyaluronic acid gel after subcutaneous injection within the temporal hollow. Histology confirmed consistent placement of the gel within the subcutaneous tissues, but it also showed that injection in this region may produce unintended deeper location of filler, and a significant perivascular collection of the material. The proximity of dense temporal fascial and muscle arterial networks in this region may pose risk for perivascular injection and associated complications.
authors.affiliation: *Cole Eye Institute, Cleveland Clinic; †Department of Anatomy, Cleveland Clinic Lerner College of Medicine; and ‡Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, U.S.A.
authors.forename: Rao V
authors.initials: RV
authors.lastname: Chundury
authors.forename: Adam C
authors.initials: AC
authors.lastname: Weber
authors.forename: Jennifer
authors.initials: J
authors.lastname: McBride
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Plesec
authors.forename: Julian D
authors.initials: JD
authors.lastname: Perry
mesh_terms: D020405:Dermis / Q000033:anatomy & histology*; D005152:Facial Muscles / Q000033:anatomy & histology; D005205:Fascia / Q000033:anatomy & histology*; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007279:Injections, Subcutaneous; D013701:Temporal Bone / Q000033:anatomy & histology; D013703:Temporal Muscle / Q000033:anatomy & histology*
chemical_list: C584568:belotero balance; D006820:Hyaluronic Acid