In this post:

Discover why temple filler is considered one of the most complex and challenging facial rejuvenation treatments.
Learn about the intricate anatomy of the temples and the critical safety considerations of temple filler treatments.
Explore three advanced injection techniques used by expert practitioners, including subcutaneous, interfascial, and supraperiosteal approaches.
Understand how ultrasound technology is revolutionizing temple filler treatments by enhancing precision and minimising vascular complications.

In the past few years, we’ve seen non-surgical cosmetic treatments explode in popularity, and dermal fillers remain at the forefront of the aesthetic medicine industry. While most of us are aware of the transformative effects of lip and cheek filler, another treatment area is often overlooked: temple filler.

Temple filler is a treatment that can produce impressive, age-defying results. However, it’s also known as one of the most challenging areas of the face to treat.

There are two reasons for this: the complex anatomy of the temple and the risks for serious complications. Injecting temple filler is not as straightforward as lip filler, and it requires significant skill to get right. For injectors, this means undergoing advanced training to gain an in-depth understanding of temple anatomy and learn precision-guided injection techniques.

In this blog post, we’ll explore everything you need to know about temple filler, from its aesthetic benefits to the cutting-edge tools and techniques that can make this procedure safer for your patients.

What is Temple Filler?

Temple filler is a dermal filler treatment designed to restore volume to the temple area, which naturally hollows with age. This treatment rejuvenates the face by improving facial contour and balance. It can complement other treatments like cheek or jawline filler.

If you’re a patient, temple filler offers you a chance to give your features a refresh without dramatically altering your appearance. The temples are a surprisingly impactful feature when it comes to facial harmony. It’s one many overlook. Hollow temples cast shadows, making the face look aged, gaunt, or tired.

Temple fillers can restore volume in this area, which results in a smoother, more youthful transition between the forehead, brows, and cheeks.

How Does Ageing Affect the Temples?

But why exactly do we lose volume in the temples with age? There are several reasons it can happen, a lot of it purely down to genetics. Some may experience more significant volume loss in the temples than others. The temples lose volume over time due to:

Fat pad atrophy: Loss of superficial and deep fat pads diminishes structural support
Bone resorption: The temporal bone shrinks with age, contributing to a hollowed look
Skin thinning: Collagen depletion makes the skin more fragile

These changes can start in our late 20s, but often go unnoticed for decades. Only when the hollowing becomes pronounced do we see the peanut-shaped indentation on the sides of our upper face. You might especially notice this change when applying makeup or styling your hair. Luckily, temple fillers are an excellent tool for fixing this “sunken” look.

Is Temple Filler Dangerous?

We’ve already mentioned the temples are one of the most technically challenging areas of the face to inject. This does not mean temple filler is inherently dangerous. When performed by a trained professional, temple filler is very safe. But even so, it’s not without risks.

Complications are rare and can range in severity. Mild swelling and bruising are common side effects, and they are usually nothing to be concerned over. However, more serious outcomes like vascular occlusion can occur when temple filler treatment is attempted by inexperienced hands.

The reason temple filler is a higher risk treatment is because the temple is home to critical blood vessels, including the superficial temporal artery (STA) and its branches, as well as deeper structures like the deep temporal arteries. If filler enters these vessels, it can lead to life-altering consequences like:

Tissue death
Blindness
Stroke

Why Experience Matters

Because of these risks, we cannot emphasise enough that temple filler should only be performed by trained injectors with extensive knowledge of the area’s anatomy. Advanced safety measures, like the use of facial ultrasound (more on that later), further reduce risks by allowing injectors to map out vascular structures and plan the treatment in real time.

For patients, choosing the right practitioner is critical. As tempting as it may be to book the cheapest treatment, expertise and safety should always come first.

Hear from Smileworks Aesthetic Training HUB lead instructor and founder Dr MJ for more on why temple filler is such a risky treatment:

Understanding Temple Anatomy

The temples are deceptively complex, requiring a meticulous approach in order to place filler safely and effectively. Aesthetic boundaries of the temple include the later brow, the hairline, the frontotemporal crest, and the zygomatic arch. Beneath the skin lies a layered structure that can be challenging for beginner injectors to navigate.

The Temple’s 10-Layer Structure

The temple is composed of 10 distinct layers, each with specific implications for filler placement:

1. Skin
2. Subcutaneous Tissue
3. Superficial Temporal Fascia (Temporoparietal Fascia)
4. Deep Temporal Fat Pads
5. Deep Temporal Fascia
6. Superficial Temporal Fat Pad
7. Deep Lamina of Deep Temporal Fascia
8. Deep Temporal Fat Pad
9. Temporalis Muscle
10. Periosteum & Temporal Bone

The safest planes for filler injection are typically the deep temporal fascia or directly on the periosteum. These layers minimise the risk of vascular compromise while providing optimal volume restoration.

Vascular Landmarks

Key arteries in this area include the STA and its zygomatico-orbital branch, which runs just below the skin’s surface. Deeper injections must account for the deep temporal arteries. Without careful mapping, injecting into or compressing these vessels can lead to serious complications.

Temple Filler Injection Technique

Pre-Treatment Assessment

Safe temple filler injections begin long before the needle or cannula touches the skin. A thorough assessment includes:

Patient consultation: identify volume deficits and discuss aesthetic goals
Ultrasound mapping: use ultrasound to identify and avoid vascular structures during treatment
Skin evaluation: assess for thin or sun-damaged skin that may affect results

Temple Filler Injection Techniques

There are a variety of different techniques an injector can employ when injecting in the temporal region. Understanding and carefully selecting the appropriate injection technique is crucial for achieving optimal results for your patients.

Due to the complex multi-layered anatomy of the temple, filler placement is generally focused on three key layers. Each technique targets specific areas and requires a deep understanding of anatomy.

1. Subcutaneous Technique

The subcutaneous technique involves injecting filler into the second layer with using a cannula, typically for mild to moderate temple volume loss. This layer is superficial, with generally no major blood vessels, reducing vascular risks when performed correctly. A low G-prime product is ideal here to prevent lumpiness since the tissue covering is thin.

However, achieving precise depth control in this layer can be challenging. If the cannula inadvertently dives deeper, it risks injuring the superficial temporal artery, especially in lateral areas near the hairline. Due to these risks, ultrasound guidance is critical to safely execute this temple filler technique, ensure accurate filler placement, and avoid complications.

2. Interfacial Technique

The interfascial technique targets the deep fat compartment in the fourth layer. This technique also employs a cannula and is suitable for treating mild to moderate temple volume loss. The benefits include a visible reduction in the temporal crest and an improved position of the lateral brow.

This layer requires a low to moderate G-prime product to provide support while maintaining natural movement and structure. The primary risk here is the sentinel vein, which can cause significant bruising if injured. Locating this precise layer without ultrasound is difficult, which only emphasises the importance of real-time imaging for safety and precision.

3. Supraperiosteal Technique

The supraperiosteal technique, often referred to as the “one up one over” or “gunshot” technique, involves placing filler in the supraperiosteal plane. This technique uses a needle positioned perpendicular to the temple, touching the periosteum. This method is particularly effective for patients with moderate to severe temple volume loss and uses a moderate to high G-prime product for structural support.

This layer is commonly thought to be a safer layer due to the perceived absence of blood vessels. However, the deep temporal artery branches may lie on the periosteum, posing a risk of vascular occlusions. Additionally, filler placement in this plane is typically intramuscular, as the temporalis muscle is tightly adhered to the underlying periosteum.

But this is just a taste of the different temple filler injection techniques. There’s also variations when injecting for posterior temple augmentation, which Dr MJ will delve into during her 1-2-1 mentoring sessions. Which technique you choose can also depend on the degree of volume loss, a patient’s individual anatomy, and your level of expertise.

Ultimately, ultrasound guidance is the single most important way to plan and execute safe, effective filler treatments.

When Ultrasound is a Game Changer

Ultrasound technology is transforming temple filler treatment. Because of its ability to provide real-time imaging, ultrasound allows injectors to visualise the exact location of vascular structures, filler placement, and the surrounding anatomy.

While the benefits of using facial ultrasound to inject are endless, here are the three key benefits:

Enhanced Safety: avoid arteries and veins with precision
Informed Decision-Making: plan injection depth and filler placement with the use of real-time images
Reduced Complications: minimise the risk of vascular occlusion and other adverse events

Our online facial ultrasound course is a prerequisite for all of our 1-2-1 mentoring sessions. Dr MJ is an advocate for ultrasound-guided injections and believes this tool is essential and necessary for injectors working in high-risk areas like the temples.

Learn Aesthetic Medicine From The Pros

If you’re looking to learn the art of temple filler, allow us to formally introduce ourselves. We’re the Smileworks Aesthetic Training HUB – an esteemed aesthetic training centre based in the UK. We pride ourselves on our wide range of online and hands-on courses tailored for every skill level.

If you’re after more in-depth training in temple filler, book a one-to-one mentoring session with our lead instructor and co-founder Dr MJ Rowland-Warmann. You’ll receive personalised instruction that will leave you prepared to treat real patients right away.

Maybe you’re only just taking your first steps into the world of Botox and lip filler or you’re an advanced injector aiming to master facial ultrasound techniques. Regardless of your experience, the HUB has the expertise and courses to suit your needs.

It’s time to embrace the prospering world of aesthetic medicine. The HUB provides you with all the right training and guidance you need to succeed. Take control of your professional journey and step into a future filled with endless potential and opportunities.

Join us at the HUB. Let’s shape the future of aesthetic medicine together and ensure safe, effective, and transformative results for every patient.

Want to try out our courses before committing? Take advantage of our free trial for a taste of what learning at the HUB is like.

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