The temporal reduction surgical technique (often called temporal narrowing or temporal contour reduction) is a skull contouring procedure aimed at reducing excess width or fullness in the temporal region (the sides of the head above the ear). It is most done in males who want a more vertically shaped side of the head and may be considered a facial masculinization surgery (FMS) procedure.
The technique is done through a high postauricular incision which provides direct access to the deep temporal fascia (green line). Underneath the fascia the entire posterior temporal muscle is removed using a full thickness oblique cut line running from the top of the ear up to the side of the forehead (purple line). In select cases of anterior temporal muscle fullness the remaining muscle may be transposed through the same incision to reduce fullness in that area as well.
The inclsion is closed over a drain after fascial closure which is essential to dampen the appearance of the cut edge of the muscle. The postauricular incision is closed ober a drain in multiple layers with resorbable sutures.
The postauriucular incision heals beautifully with no visible scar or distortion of the shape of the upper ear.
The postauricular incision provides a virtually ‘scarless’ approach to the side of the head. It is a limited incision but that is all that is needed for temporal muscle removal. It does not provide adequate exposure for much temporal bone removal however.
Dr. Barry Eppley
World-Renowned Plastic Surgeon