Temporal reduction is an effective strategy for reducing the width of the side of the head. The temporal region makes up the entire width of the head and is uniquely different from the rest of the skull. It is the only area of the skull in which a large muscle layer exists which contributes significantly to the shape and width of the side of the head. It is this unique anatomy that is the basis for temporal reduction surgery.
In performing the temporal reduction procedure it has evolved to the point where having a completely hidden scar is an essential part of the surgical outcome. From this incision in the crease of the back of the ear an angled cut is made through the released muscle from the top of the ear up to some point along the bony temporal line.
While this full thickness muscle cut was initially done in an almost vertical fashion, it has evolved over the years to have a more anterior angulation. By angulating the muscle cut more forward more of the anterosuperior muscle is removed which makes the width reduction effect more complete . This is an effective modification for those patients who have head width concerns that extend more anteriorly closer to the forehead.
Removing more of the temporal muscle does not have any functional sequelae nor does it require that the incisional access is any longer. It also does not create more swelling or extend one’s recovery. It merely makes for an enhanced aesthetic outcome in the patient with fullness that also involves some of the anterior part of the muscle..
Dr. Barry Eppley
World Renowned Plastic Surgeon