The temporal area is a unique facial implant site for augmentation because it is not a skeletally based implant site and technically is not on the face. It is really augmentation of the temporal muscle, whether it is the non-hair bearing traditional temporal hollows (anterior temporal zone) or the hair-covered posterior temporal zone above and around the ears.
While there are standard temporal implant styles for augmentation of the anterior temporal hollows, no such implants exist that can provide posterior temporal augmentation or to extend up to the forehead and across the temporal line. Such types of temporal augmentation provide forehead widening as well as creates a head widening effect. (increased posterior temporal convexity) Custom designed temporal implants can be designed to create augmentation of what is often seen as too narrow of a forehead or pinched side of the head.
The placement of custom temporal implants can be done at carious tissue planes on the side of the head based on the size of the implant. They can be placed under the muscle, on top of the muscle but under the fascia or on top of the fascia depending upon how far forward the augmentation is needed. (does it need to to cross onto the forehead over the temporal lines) Regardless of the temporal implant size it is placed in a scarless fashion from an incision behind the ear in the postauricular sulcus employing the principles of implant deformation and intrapocket elastic shape recoil.
Dr. Barry Eppley