Aspen, Colorado – Successfully filling the temporal area requires sound technique and a 3-dimensional approach, said Kenneth Beer, M.D., at The Cosmetic Bootcamp.
As the temporal area ages, he said, changes include not only fat loss from the retro-orbicularis oculi (ROOF) fat pad, but also loss of other soft tissues and bone. People also can develop sun damage, skin laxity and muscle atrophy. “We’re trying to replace a 3-dimensional, multi-structural loss with one injection.”
When filling the temples, “There are many different opinions. Calcium hydroxylapatite (CaHa), hyaluronic acid (HA) and poly-L-lactic (PLLA) all are effective. Then there are technical considerations. When I’m injecting in this area, I’m on the bone, as deep as possible. I inject very slowly and aspirate whenever possible.” He also uses his non-dominant hand to compress the area. “I keep the needle relatively stationary and use my nondominant hand to guide the flow to different areas. I can usually get most of the temporal areas filled effectively with one or 2 sticks. That minimizes the risk.”
Avoiding the area within one centimeter of the suture line preserves the temporal artery, which courses across the forehead, said Dr. Beer, who uses cannulas for the temples about half the time. “The cannula reduces risk to a minimal level – probably not zero, although I have not heard of anybody having a vascular incident with one.”
Dr. Beer is a CBC cofounder, an associate clinical professor of dermatology at the University of Miami Miller School of Medicine, a consulting associate with Duke University and a clinical associate in dermatology, University of Pennsylvania Perelman School of Medicine.
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