Temporal Hollowing Correction

Q: Dr. Eppley, I am interested in temporal hollowing correction surgery. I have attached some pictures of my temporal areas. My temporal hollowing tarted after I had filler injected into my cheeks four months ago. I had one syringe of Voluma in each check, the “apple” area of the cheek only, but injected quite deep (near the bone).  On the left side of my face, some of the filler formed a lump which was sitting on nerves and causing pain and numbness in my face and severe pain shooting up into my head.  My temples began to disappear as did my upper eyelids.  The temple on the left side is worse since that is where the pain was more severe.  I went for several treatments to dissolve the filler.  The pain is not as bad now, but I still have pain and this is one of my concerns.  Because I am still experiencing pain in my head (including temple area), I don’t know if I should wait or try fillers first or fat transfer.  I don’t want to make the situation any worse. 

I would appreciate your feedback.

A: Thank you for sending your pictures and detailing your recent history. While I have done many cases of severe temporal hollowing correction before, your recent of history of acute temporal hollowing (due to fat atrophy) is not one that I have ever seen or heard of before. The exact mechanism behind such an acute and unprecedented temporal change can be hypothesized but the actual mechanism will probably never be known. (possible vascular compromise of the buccal fat pad??)

While I think temporal implants are the most effective treatment for your severe temporal hollowing, I don’t think you should do anything until your pain symptoms have completely resolved and the degree of temporal hollowing has stabilized. 

Dr. Barry Eppley

Indianapolis, Indiana