Temporal Artery Ligation
Q: Dr. Eppley, Since my original temporal artery ligation operation I seem to have developed small vein grooves around the same area where the arteries ran. These are definitely from veins as they are sort of dents running straight down across the artery path, and when i put my head down low the veins bulge out there. These grooves were also present before, just to a lesser degree but seem to be worse since I had the original operation.
I am not sure how much this worsening is due to the original operation, and how much is just due to further fat loss/skin thinning which would have happened anyway. However, these areas don’t really bother me that much.
My area of concern is I seem to have a groove that runs up the side of the temple and along the top of the front path of the head – around the coronal suture path. Again I am fairly sure this is a vein, as it seems to branch off and also when i put my head down it fills out pretty flush. I also have this to a lesser degree on the other side. Being balding, i can see the two lines will meet up in the middle leaving me with a nice dent across my head !
I have attached a picture here, i have caught it in the worst possible light – i have gone back through lots of old pics and can’t see this at all, but the angle has to be right to see it like this.
My questions are:-
-Firstly is this actually an artery and so would the operation somehow help it (though I can’t see how reducing something that is a dent would help)
-Is it possible that this can have been caused by the original temporal artery ligation operation somehow
-If so, would a further tie off to close the remaining lower bulge potentially make this problem worse
-If so, is there any other alternative at all – i did note you mentioned on another question about temporal implants – would they be suitable for hiding the lower grooves and whats leftt of the bulging artery
-Is there any way at all to fill in the groove that has developed going across my head.
Thank you very much indeed.
A: In answers to your temporal artery ligation questions:
1) I can not say just based on a picture as to the anatomic basis of the groove to which you refer. But I doubt very highly that it is an artery. However I have seen many grooves along the coronal suture line in the skull that look like yours as they represent depressions/dent in the underlying bone/suture lines
2) Temporal artery ligation is not going to cause a sutural bone indentation.
3) Nothing done to the superficial temporal vascular system below should affect, positively or negatively, the dent along the suture line.
4) and 5) Fat injections is the simplest and likely most effective approach for filling in these skull dents/grooves.
Dr. Barry Eppley