Does Ligating The Superficial Temporal Artery Risk Causing The Eyelid To Droop?

Q: Dr. Eppley, I am a 57 year old male in good health, who exercises regularly and watches what I eat. Over the last couple of years, my temporal artery on the right side of my forehead has become more pronounced. I visited a vascular surgeon, who said there was no medical reason to do anything. The vessel is very noticeable and I wanted to know if there was anything that could be done to hide it. I am concerned because the surgeon said its removal could cause other issues (eyelid drooping).

A: Ligation of the branches of the superficial temporal artery (STA) can be done to reduce its prominence. The main trunk of the STA lies in the temporal hairline and is far removed from any branch of the facial nerve.  But reduing anterograde (forward flow) of the STA is usally not eough to reduce its visible pulsatile appearance. Retrograde (backward flow) from the STA from its distal extension in the forehead must also be done. (two-point ligation) This is done through a small stab incision somewhere on the forehead where the tail of the visible artery can be seen. This also has a very low risk of injury to the frontal branch of the facial nerve which supplies the forehead and upper eyelid closure.

Dr. Barry Eppley

Indianapolis, Indianapolis