Temple filler: how treating temple hollowing changes your whole face

Temple hollowing is one of the most underestimated contributors to facial aging. Patients who come in complaining about looking "gaunt," "skeletal," or "tired" despite having adequate mid-face volume often have significant temporal volume loss that they haven't noticed specifically — because the temples aren't an area most people study in the mirror.

Why the temples matter to overall facial appearance

The temporal fossa (temple area) forms the upper lateral boundary of the face. When full, it creates:
A smooth, convex curve from the brow to the cheek
A sense of facial fullness and health
A structural frame for the eye area

When hollow, the temples create:
A skeletonized appearance around the eye socket
A "caved in" or gaunt look when viewed from the front or at an angle
The appearance of heavy or protruding brows (the brow hasn't moved — the tissue behind it has thinned, making the brow bone look more prominent)
A sharp angle at the skull-to-face transition

This skeletonized appearance is strongly associated with advanced aging and illness — which is why treating it produces a rejuvenating effect that can't be achieved by treating other areas alone.

Who gets temple volume loss

Temple hollowing is driven by fat pad atrophy (the temporal fat pad, like other facial fat compartments, diminishes with age) and some degree of temporal muscle reduction. It begins in the 30s and becomes more pronounced through the 40s and 50s.

Patients who are very lean or athletes often develop early and more pronounced temporal hollowing because they have less overall body fat including facial fat.

The filler approach

Product choice: Thick, structural fillers are appropriate for the temple because the volume needed can be significant (1–3 mL per side in some cases) and the area is over a bony surface:
Juvederm Voluma — high G', structural; commonly used
Restylane Lyft — another structural option
Sculptra — a biostimulator; multiple sessions build collagen gradually; excellent for broad temporal restoration without a "filler" appearance

Injection approach: Two main techniques:

Supraperiosteal (deep) injection: Filler placed directly on the bone surface. Structurally sound; least vascular risk because it's below the superficial temporal vessels.

Intramuscular or subcutaneous injection: Higher layers; can look more natural but carries higher vascular risk because the middle temporal vein and superficial temporal artery run in this zone.

Most experienced injectors use a combination approach, placing the majority of product at the bone and a smaller amount more superficially for contouring.

The vascular risk in the temporal region

The temporal region contains the middle temporal vein (a significant vessel that runs through the temporal fat) and the superficial temporal artery (a branch of the external carotid that crosses the temple superficially). Vascular occlusion in this area has caused skin necrosis and, in rare reported cases, retinal artery occlusion (vision loss) through retrograde flow.

This makes the temple an area where:
Aspiration before injection is used by many experienced injectors
Cannula technique (reduces risk of intravascular injection) is preferred by many providers
Slow, incremental injection is standard
Only injectors with strong anatomical knowledge should perform this treatment

The risk is real but low when performed by properly trained providers. It is not a reason to avoid treatment — it is a reason to select your provider carefully.

What to expect

Volume: Most patients need 1–2 mL per side for meaningful improvement; patients with severe hollowing may need 2–3 mL per side. With Sculptra, volume is achieved over 3 sessions.

Immediate result: Immediate improvement visible. The full integration and any swelling resolution takes 2–4 weeks for HA fillers; 3–6 months for Sculptra.

Duration: Voluma/Lyft in the temples: 18–24 months (longer than in more mobile areas). Sculptra: 2–3 years.

Session: 20–30 minutes. Topical numbing is applied; some providers use lidocaine in the dilution or a local nerve block.

Downtime: Mild bruising possible; tenderness for 1–3 days.

Cost

| Treatment | Volume | Cost |
|---|---|---|
| Mild hollowing (both temples) | 1–2 mL total | $800–$2,000 |
| Moderate hollowing (both temples) | 2–4 mL total | $2,000–$4,000 |
| Sculptra (course of 3 sessions) | 3–6 vials | $2,100–$5,000 |

Why injectors sometimes recommend temples when you ask about other areas

A patient who comes in asking about nasolabial folds, jowling, or "looking tired" may hear their injector recommend starting with temple filler rather than directly treating the presenting complaint. This is often correct:

Restoring the upper facial foundation (temples + cheeks) improves the rest of the face without adding volume to the lower face
Adding filler to nasolabial folds without addressing the structural deficit can make the face heavier rather than more youthful
The temples, along with the cheeks, form the "scaffold" of the face — fixing the scaffold often makes surrounding concerns less prominent

This is a sign of a sophisticated injector who thinks about the face as a whole rather than treating one complaint in isolation.

Questions to ask your provider

Do my temples appear hollow, and is this contributing to the aged appearance I'm concerned about?
Do you use a cannula or needle for temporal injection, and what's your reasoning?
Would you recommend HA filler or Sculptra for my degree of hollowing and overall goals?
How much product do you estimate I need, and can we start with a conservative amount?
How does treating my temples fit into an overall facial rejuvenation plan?

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