Where Are Temporal Implants Placed, Above or Below the Muscle?

Q: Dr. Eppley, Wwhat kind of temporal implants do you use? I have read that Medpor temporal implants has to be screwed under the temporal muscle onto the temporal bone. Is that the way you do it? Will the scalp incisions be bad in that case? Thank you very much.

A: There are different indications for temporal augmentation and that determines the type of implant used and its location. For cosmetic augmentation and in mild muscle atrophy after a craniotomy, the implant is placed under the fascia (on top of the muscle) in most cases. I prefer the use of soft flexible silicone rubber temporal implants when it is placed in this more superficial location. This is done through a very small vertical incision in the temporal hairline that heals inconspicuously. In more severe atrophy cases after craniotomy or at the time of a craniotomy, the implant is placed next to the bone and often needs to be larger. This is where a Medpor temporal implant is used as it is meant to be placed next to the bone and is usually screwed into place. It is placed through an existing larger scalp coronal incision.

Dr. Barry Eppley

Indianapolis, Indiana