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Dr. Barry Eppley

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Posts Tagged ‘extended temporal implants’

Extended Temporal Implants

Wednesday, May 4th, 2016


Temporal implants are becoming a permanent treatment option for temporal hollowing. They offer a simple surgical solution using ultra soft solid silicone implants placed in the subfascial location through a small incision behind the temporal hairline. They have proven to be more than capable of creating an adequate temporal augmentation effect, equating to over 2mls of injectable filler (by the water displacement test) for a small standard sized temporal implant.

But as the experience with temporal implants increases, it has become apparent that some patients have temporal hollowing concerns that extend all the way superiorly to the forehead. Thus temporal hollowing concerns can be limited to the area to the side of the eye or extend all the way up to the anterior temporal line. (which some call the side of the forehead) The first generation standard temporal implant only creates its augmentation effect to the temporal concavity at the side of the eye.

Extended Anterior Temporal Impalnt design side view Dr Barry Eppley InsianapolisExtended Anterior Temporal Implants technique 1 Dr Barry Eppley IndianapolisA newer second generation style of temporal implant has been developed that augments the entire temporal region. It is vertically longer so that its superior edge sits right under the temporal line of the side of the forehead in its subfascial location. It is inserted with the same surgical technique as the standard temporal implant but with a few minor modifications of the basic technique.

Extended Anterior Temporal Implants technique 3 Dr Barry Eppley IndianapolisExtended Anterior Temporal Implants technique 4 Dr Barry Eppley IndianapolisThe temporal hairline incision will be about an additional .5 cm longer. (3 to 3.5 cms) The dissection heads down to the deep temporalis fascia through a branch of the superficial temporal artery will almost always be encountered. The deep temporalis fascia is incised at a length that is much greater than the length of the skin incision. The subfascial pocket is elevated widely all the way up to the bony temporal line.

Extended Anterior Temporal Implants technique 5 Dr Barry Eppley IndianapolisExtended Anterior Temporal Implants technique 6 Dr Barry Eppley IndianapolisThe extended temporal implant is introduced in the subfascial pocket horizontally and then changed to a vertical position once inside. The upper and lower ends of the implant are checked for position and the incision closed in layers including the deep temporalis fascia.

The extended temporal implant offers a broader anterior temporal augmentation effect for those patients with larger or more extensive temporal concavities. Despite its bigger size, it can still be placed through a small incision in the temporal hairline.

Dr. Barry Eppley

Indianapolis, Indiana

Technical Strategies – Extended Temporal Implants

Sunday, February 14th, 2016


Temporal implants have become the surgical approach to the treatment of temporal hollowing.  They offer a rapidly performed permanent solution that eclipses the temporary and inconsistent effects of synthetic fillers and fat injections. These implants are placed in the subfascial location on top of the temporalis muscle through a small vertical or obliquely oriented incision back in the temporal hairline.

As the use of temporal implants has increased, new styles have emerged. The initial temporal implant design was designed to treat the deepest part of the temporal hollows by the side of the eye. These implants only went up about as high as the lateral brow bone.

Extended Anterior Temporal Implant Dr Barry Eppley IndianapolisBut as more experience with temporal implants has evolved, it become clear that the extent of bothersome temporal hollowing can extend all the way up to the side of the forehead. (anterior temporal line) This has led to an extended style of temporal implants that provides some augmentation much higher than the standard style. (up to 6.5 cm vertical height from the zygomatic arch)

Temporal Implants Incision and Insertion Dr Barry Eppley IndianapolisWith such a larger temporal implant, the concern would be that a much larger incision would be needed for its placement. To avoid more than a 3 cm to 3.5 cm incision, the key is to make the subfascial pocket through a small incision. This is easy to do with instruments in a blind fashion. Then the implant can be inserted lengthwise in a rolled fashion. Once making its way through the small incision, the implant is unfurled and rotated into the proper position.

Larger styles of temporal implants can still be inserted through relatively small temporal hairline incisions. This makes the appeal of temporal implants for larger areas of temporal hollowing equally appealing as smaller amounts of temporal hollowing.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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