Are Temporal Implants Placed Above Or Below The Temporalis Fascia?
Q: Dr. Eppley, I’ve heard that you perform temporal implants. Where does these implants go, is it under the superficial temporal fascia or the deep temporal fascia? I have heard the deep temporal fascia cannot stretch to cover an implant. Is that true? Also, does this implant reach down to the zygomatic arch and can these implants become infected? Thank you so much.
A: They are almmost always placed under the deep temporal fascia. There is no problem with the fascia stretching to cover it and the fascia is often released along the lateral orbital rim and superior zygomatic arch to accomodate bigger implants. I have rarely put temporal implants on top of the deep temporalis fascia as there is the possibility that the dissection or the pressure of the implant may injure the frontal branch of the facial nerve. The lower edge of temporal implants almost always extends down to the zygomatic arch. Like all facial implants, there is a risk of infection but this is usually very low around a 1% chance.
Dr. Barry Eppley