Should Temporal Implants Be Placed Above Or Below The Temporalis Fascia?
Q: Dr. Eppley, can a temporal implant be placed on top of the temporalis facia instead of under it? Or is the risk it to become misplaced easier on top of the fascia? As the hollowing is deepest just above the zygomatic arch, so can the implants be used to correct this? And can you tell me how much this surgery costs? Many thanks.
A: A temporal implant is usually placed under the deep temporalis fascia. It can be placed on top of the deep fascia, if the aesthetic need dictates, but this does pose some potential risk for nerve injury. The frontal branch of the facial nerve is exposed to risk of injury as it courses through this area under the skin, resulting in either temporary or permanent forehead/brow paralysis. As long as one stays directly on top of the deep temporlais fascia while doing the pocket dissection, this risk is very low. Since the hollowing is usually in the middel portion of the temporal zone, that is exactly why placing a temporal implant under the fascia corrects that area the best. But in cases where the deepest indentation is right up against the zygomatic arch, placement of the implant on top of the deep fascia may be needed to fill out that area. The complete costs of temporal implants is in the range of $5500 which may vary based on what type of implant material is used.
Dr. Barry Eppley