Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Nov-Dec;24(6):501-503.
doi: 10.1089/fpsam.2022.0176.

Ultrasound-Guided Temple Filler Injection

Stella Desyatnikova  1
Affiliations
Review

Ultrasound-Guided Temple Filler Injection

Stella Desyatnikova. Facial Plast Surg Aesthet Med. 2022 Nov-Dec.

Abstract

Temple filler volumization can significantly improve facial balance and appearance, but has significant risks, including contour irregularities, vascular occlusion, skin necrosis, hair loss, blindness, stroke, and nonthrombotic pulmonary embolism. To improve the safety and precision of temple volumization, we have introduced ultrasound-guided injections of hyaluronic acid filler. We use the interfascial space as a target for our filler placement. We review relevant anatomy, including figures, describe a technique of ultrasound-guided filler injection in the interfascial plane with real-time visualization of the cannula and filler deposition, and include a detailed video of the procedure.

PubMed Disclaimer

Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Temple ultrasound anatomy. Orientation of the probe is as shown. Interfascial space is a thin layer in yellow. The superficial temporal artery is anechoic (black) outside the color box, and colored (blue and red) in the color box on the Duplex ultrasound image, between the layers of superficial temporal fascia.
FIG. 2.
FIG. 2.
A 48-year-old patient. Hyaluronic acid filler 1.0 mL was injected to each temporal fossa. (A) Preoperative front view. (B) Postoperative front view after 1 month. (C) Preoperative ultrasound image of the temporal fossa. (D) Postoperative ultrasound image of the temporal fossa after 1 month. Anechoic (black) filler in the interfascial space, with visible septations of the loose connective tissue. Structures on ultrasound images: 1. Intermediate temporal fat pad 2. Temporalis muscle 3. Filler in the interfascial space
See this image and copyright information in PMC

Comment in

References

    1. Wang HC, Yu N, Wang X, et al. Cerebral embolism as a result of facial filler injections: A literature review. Aesthet Surg J 2022;42(3):NP162–NP175; doi: 10.1093/asj/sjab193. - DOI - PMC - PubMed
    1. Kapoor KM, Bertossi D, Li CQ, et al. A systematic literature review of the middle temporal vein anatomy: ‘Venous danger zone’ in temporal fossa for filler injections. Aesthetic Plast Surg 2020;44(5):1803–1810; doi: 10.1007/s00266-020-01791-2. - DOI - PubMed
    1. Cotofana S, Gaete A, Hernandez CA, et al. The six different injection techniques for the temple relevant for soft tissue filler augmentation procedures—Clinical anatomy and danger zones. J Cosmet Dermatol 2020;19(7):1570–1579; doi: 10.1111/jocd.13491. - DOI - PubMed
    1. Cohn JE, Pion T, Greco TM. “Not above, not below: Right in the middle!”—Novel filler technique for temporal augmentation and rejuvenation. Facial Plast Surg 2020;36(5):623–627; doi: 10.1055/s-0040-1709710. - DOI - PubMed
    1. Lee W, Park JW, Yang EJ. Temple augmentation by injecting a hyaluronic acid filler between the superficial and deep temporal fasciae. J Cosmet Dermatol 2022. - PubMed

Substances