The side of the head is typically seen or described as the area above the ears. It is influenced by a variety of constituent anatomic structures including bone, muscle and skin. Their thicknesses and the ratio of tissue proportions between them all contribute to the flatness or convexity of the side of the head. The side of the head can anatomically be described as the posterior temporal region since this is where the posterior belly of the temporalis muscle runs up over the convex skull shape (temporal and parietal bones) underneath it.
Aesthetic concerns about the shape of the side of the head do exist and I have seen patients feel that either it is too flat (not enough convexity) or is too full or wide. (too much convexity) In cases of a desire for greater width or fullness to the side of the head, the method of augmentation is with a custom posterior temporal implant. (side of the head implant).
Placed either under the fascia on top of the muscle or in a completely submuscular position, the posterior temporal implant can increase the convexity or width of the side of the head above the ears as seen in the frontal view. The typical implant thickness is in the range of 3 to 7mms. When you add up both sides that could be a change of 6 to 15mms. The incisional access for placement of posterior temporal implant is either from a small vertical incision in the temporal scalp above the ear or from an incision behind the ear in the postauricular skin crease. The incision choice is based on implant size and thickness as well as the hairstyle of the patient. The point of incisional access determines whether the implant is placed on either top of the muscle or underneath it.
Dr. Barry Eppley
Indianapolis, Indiana