Q: Dr. Eppley, I have prominent ‘ridges’ in the temporal region of my forehead (see example in attached image). Please could you advise on my options for reducing the prominence including thoughts on best method for a good outcome, either as a one off long term correction or ongoing ‘management’ and associated costs, and the degree of confidence in achieving a good outcome.
A: What you are referring to are the anterior temporal lines along the sides of the forehead. They are the near 90 degree transition between the sides of the bony forehead and more vertical temporalis muscle. They represent the attachment of the temporalis fasica and muscle to the side of the forehead. Temporal reduction in appearance can be done by either direct reduction by bone burring or augmenting the upper temporalis muscle with either injectable fillers, fat injections or temporal implants. The choice between reduction vs augmentation depends on how you want the contour of the side of the forehead/upper temporal region to be.
It would be easier to reduce the appearance of the temporal lines by augmenting the upper temporal region by either fat injections or extended anterior temporal implants. Bone burring will require an incision for access which is hard to hide in the forehead/frontal hairline region.
Dr. Barry Eppley