Temporal Artery Ligation

Q: Dr. Eppley,I went to plastic surgeon to get rid of those temporal artery frontal branches. The surgeon cut a 1 cm section off from both sides from the lowest part at the hairline. Even with the 1 cm section of the artery gone it is still bulging and pulsating. How can this be, is there some backflow from the scalp to this artery? The surgeon said that I should wait for a couple of days to see if it was success even though the artery is still bulging. This is just a nightmare, how can I get rid of these ugly bulging arteries.

A: I would need to see pictures of where your temporal artery ligations were done. A single point ligation (or even artery removal in that location) rarely works in my experience. It takes at least 2 and sometimes up to 4 ligations points to be effective in some patients due to the sinuous pattern of the superficial temporal artery. The takeoff of the anterior branch of the superficial temporal artery is variable not to mention the issue of back flow from an arterial system that extends into the scalp. It is a complex blood flow system that is not an easily reducible as one would think by just cutting off one point of inflow.