title: Temporal fossa defects: techniques for injecting hyaluronic acid filler and complications after hyaluronic acid filler injection.
abstract: Facial changes with aging include thinning of the epidermis, loss of skin elasticity, atrophy of muscle, and subcutaneous fat and bony changes, all which result in a loss of volume. As temporal bones become more concave, and the temporalis atrophies and the temporal fat pad decreases, volume loss leads to an undesirable, gaunt appearance. By altering the temporal fossa and upper face with hyaluronic acid filler, those whose specialty is injecting filler can achieve a balanced and more youthful facial structure. Many techniques have been described to inject filler into the fossa including a "fanned" pattern of injections, highly diluted filler injection, and the method we describe using a three-injection approach. Complications of filler in the temporal fossa include bruising, tenderness, swelling, Tyndall effect, overcorrection, and chewing discomfort. Although rare, more serious complications include infection, foreign body granuloma, intravascular necrosis, and blindness due to embolization into the ophthalmic artery. Using reversible hyaluronic acid fillers, hyaluronidase can be used to relieve any discomfort felt by the patient. Injectors must be aware of the complications that may occur and provide treatment readily to avoid morbidities associated with filler injection into this sensitive area.
authors: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: Margit Lai Wun
authors: ML
authors: Juhász
authors: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.|Marmur Medical, New York, NY, USA.
authors: Ellen S
authors: ES
authors: Marmur
mesh_terms: D001158:Arteries / Q000473:pathology; D001424:Bacterial Infections / Q000209:etiology; D001766:Blindness / Q000209:etiology; D003288:Contusions / Q000209:etiology; D003357:Cosmetic Techniques / Q000009:adverse effects*; D000067548:Dermal Fillers / Q000008:administration & dosage*; D005145:Face; D015745:Granuloma, Foreign-Body / Q000209:etiology; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007279:Injections, Subcutaneous / Q000009:adverse effects; D009336:Necrosis / Q000209:etiology; D010146:Pain / Q000209:etiology; D012867:Skin / Q000098:blood supply / Q000473:pathology; D015595:Skin Aging / Q000187:drug effects*; D013702:Temporal Lobe / Q000033:anatomy & histology
chemical_list: D000067548:Dermal Fillers; D006820:Hyaluronic Acid
keywords: cosmetic procedure; filler; hyaluronic acid; temporal fossa; volume deficit