Prominent temporal arteries, an aesthetic forehead affliction that occurs primarily in men, is best treated by a ligation technique. Specifically this is a vessel tie off method that uses a stair step ligation approach to try and ensure that anterograde and retrograde blood flow is eliminated from the visible vessel pathway. This typically involves at least three, and sometimes four, ligation sites along the superior course of the anterior branch of the superficial temporal artery.
At the conclusion of the procedure, which is performed under local anesthesia, the flow through the artery has been eliminated as confirmed by a doppler probe. (no audible pulsatile flow…I find digital palpation not accurate enough) The small incisions are closed with small 6-0 plain sutures. The two pertinent outcome questions are how effective is the procedure long-term and how well do these small incisions heal?
In this typical 6 month outcome assessment example, the patient’s more prominent left temporal artery was ligated at four separate locations along its superior course. The outcome was complete elimination of any visible arterial show with negligible scarring.
The less visible right side was treated by three ligation locations with a similar outcome.
The vast majority of temporal ligation patients experience near to complete vessel prominent reduction that is sustained long term. While this case example is only seen at six months after the procedure, I have yet to have a patient years later that has reported back to me of any recurrence. (doesn’t mean it couldn’t happen but no one has brought it to my attention yet)
As expected these small incisions, despite their visibility in a prominent facial location, heal well and no one has ever needed a scar revision. One incision issue that occasionally can occur is the permanent suture used to tie off the vessel can in some patients develop irritation and become visible at the skin surface. (I have see this twice) But that is a problem easily solved by removing the visible suture.
Dr. Barry Eppley