Can Temporal Implants Be Put In Through A Browlift Incision?

Q: Dr. Eppley, I am interested in temporal implants but I have a twist to my need. I am bald and can’t regrow hair so I keep my head shaved. In addition I had a direct browlift last year so there are healed incisions right above my eyebrows. My question is can these implants be placed by going through the brow incisions? I hate that I would need temporal scalp incisions which would be very visible in someone like me.

A: While temporal implants may be aesthetically beneficial for you the question is how to get them in there in a ‘scarless’ manner in someone who shaves their head. This is a unique male question and not one that is seen in females. As you have read, the approach for temporal implants is from a 3 to 4cm incision just above the ear. While that approach makes it very easy and simple to do, the concept of a fine line scar in shaven scalp skin  does give me pause. Your question of whether a temporal implant can be placed through a direct brow lift incision is an interesting one and the presence of a scar in that area poses a unique ‘opportunity’. The eyebrow incision for temporal implants is one I have never done and I doubt if it has ever been done anywhere in the world to date. By its proximity your eyebrow scars provide direct access to the area of temporal hollowing but the attachment of the temporal fascia to the lateral orbital bone is quite stout and would have to be released to gain entrance to the subfascial temporal plane. (having done a lot of craniofacial surgery I am very familiar with doing surgery in this area) The simple answer to your question is that it is theoretically possible and if one was doing some adjustment of your direct brow lift anyway there is no reason not to try. If it becomes too difficult to do, one can always then switch to doing fat injection into the muscle and on top of the fascia to create a temporal augmentation effect.

Dr. Barry Eppley

Indianapolis, Indiana