Temporal Rejuvenation With Injectables: Restoring Volume and Youthfulness

Introduction:

Aesthetic professionals are becoming more interested in nonsurgical techniques for temporal rejuvenation as patient demand drives up the usage of this procedure. Nevertheless, there is no method for doing this process that is generally accepted. For people in their mid-30s or early 40s who are starting to notice the first indications of aging around the eyes, temporal lifting has the most value; it helps to eradicate the "sad" or "tired" look without requiring extensive surgery. This operation firms the outer area of the eye raises the brows, lessens the appearance of the crow's feet lines, and lightens the outer eyelid hooding. The outcome can be striking, giving the patient a "chiseled," youthful appearance with little to no bleeding, scars, or hair loss.

What Is Temporal Rejuvenation?

In the younger patient, the boundaries of the temporal area are not exact. The formation of a temporal fossa, the margins of the temporal, orbital, and zygomatic bones, the ptosis of the lateral region of the brow, and the crow's foot wrinkles all contribute to its individualization as we age. This area frames the look, thus it should be considered in the cervical and face stages as well as the clinical assessment. There are several subtle and progressive rejuvenation treatments. Both the volumizing methods and the botulinum toxin can harmoniously and efficiently respond to the patient's demands as long as the ptosis in the eyebrows is not noticeable and their distance is unchanged. The increasingly popular lipostructure (a natural, long-lasting technique that uses intricate layers of autologous tissue that has been injected to support and cover the face) treatments must, therefore, be combined with the surgical methods for temporal and brow lifts. It should be highlighted that the need for temporal rejuvenation is rising and that it comes before the need for cervicofacial renewal. This demonstrates how crucial this area is for both avoiding the process or, at the very least, slowing it down and treating the stigma associated with getting older.

What Is the Anatomy of the Temporal Area?

The temporal area is located above the zygomatic arch and is bounded laterally by the hairline and upward by the temporal crest, also known as the linea temporalis, which is the point where the frontal, temporal, and parietal bones converge. The superficial temporal fascia, also known as temporoparietal fascia, is firmly attached to the subcutaneous tissue beneath the skin and subcutaneous tissue. The superficial and deep layers of the deep temporal fascia are attached to the bony floor. These three fascial layers make up the temporal region beneath the skin and subcutaneous tissue. In temporal dissection, the Merkel space—a natural sliding area that lies between those superficial and deep temporal fascia layers—is crucial.

Sensory innervation of the temporal area is provided via the trigeminal nerve.

What Are the Products Available for the Rejuvenation of the Temporal Region?

Due to advancements in goods, techniques, and patient needs, the field of facial aesthetics and rejuvenation is continuously changing. While they still hope for optimal, successful outcomes, patients usually seek less harsh therapies with little to no downtime. A new face aging grading system, continual product assistance, treating numerous facial areas, customizing treatments for each patient, and combining products to maximize results are all beneficial to clinicians. Hyaluronic acid (HA), calcium hydroxyl-apatite, poly-L-lactic acid, and botulinum toxin type-A (BoNTA) are among the safe, efficient, and adaptable nonsurgical temporal rejuvenation therapies currently on the market.

• There are several HA products on the market, however the comments below are based on the author's particular, in-depth expertise with the Juvederm line of HA treatments. Because they contain lidocaine to lessen injection pain, cross-linked HA dermal fillers are simple to apply and well tolerated by patients.

• Juvederm Voluma is smooth, viscous, and sturdy, which makes it easy to apply during treatment and results in a full, smooth, natural look and feel. Benefits can last up to 18 months following treatment. This makes it useful for temporal rejuvenation and temporal volume restoration.

• The role of boNTA in temporal rejuvenation has been examined by a multidisciplinary group of experts in aesthetic treatment. They have concluded that when boNTA is used to decrease the activity and volume of the masseter muscles, thereby increasing the activity and volume of the other masticator muscle, the temporal muscle, additional benefits can be obtained from the combination of boNTA and HA. This increases the temporal area's volume.

To Whom Is Temporal Rejuvenation Recommended?

Based on the patient's potential for temporal rejuvenation, the author suggests using his four-point temporal aging scale as a baseline to provide an objective pretreatment assessment.

• Stage 1: A straight, convex, or normal temporal fossa.

• Stage 2: The initial indications of a mild depression (hollow).

• Stage 3: The temporal fossa is concave, and some temporal arteries are visible. The tails of the eyebrows also drop.

• Stage 4: The temporal fossa has skeletonized, revealing visible bones, prominent veins and arteries, and a significant concavity in the fossa.

In advance of therapy, the ideal aesthetic product and volume needed may then usually be determined based on the baseline temporal aging stage.

• Stage 1: No medical intervention.

• Stage 2: Apply 0.5–1 mL of a volume-restoring product or 0.4–0.8 mL of HA filler on each side.

• Stage 3: 1-2 milliliters of a substance that restores volume for each side.

• Stage 4: Apply two to four milliliters (mL) of a substance that restores volume per side.

Where Is the Temporal Rejuvenation Performed?

• Zygomatic Arch: The inferior horizontal limit is included in the zygomatic arch.

• Orbitomalar Apophysis: Anterior limit curvature is part of the orbitomalar apophysis, the lateral portion of the orbit.

• Temporal Crest: The fusion zone known as the Linea temporalis, or temporal crest, is located in between the frontal, parietal, and temporal bones. It comprises the curving superior limit, the periosteum, and the deep temporal fascia and periorbital retention ligaments.

• Hairline: The hairline encompasses the back edge of the discernible temporal fossa. The posterior marker for a patient with baldness is the point where the parietal temporal and occipital bones join, which is the end of the linea temporalis. In general, it traces the ear's contour.

After identifying these four segments, the patient can be used to draw two lines: a horizontal line from the lateral canthus and a vertical line at the midway point of the zygomatic arch. This will yield the four quadrants.

What Are the Risks Associated With Temporal Rejuvenation?

• Bruising.

• Pinprick bleeding is commonly linked to nonsurgical cosmetic procedures.

• After treatment, some patients report having slight pain for one day and for three to five days when they bite or chew.

Conclusion:

Recent years have seen considerable evolution in nonsurgical temporal rejuvenation, and patient demand—especially given its quick recovery time—has led to a rise in popularity. The best candidates for temporal facelifts are those in their mid-30s or early 40s when the surgery has a very high success rate and can produce striking results.

This research examines efficacious products that are currently on the market and offers recommendations for nonsurgical treatments for temporal rejuvenation. It is possible to determine the ideal product and volume needed before therapy to maximize benefits based on the baseline temporal aging stage.