Injectable fillers, fat and implants are all options for the treatment of temporal hollowing. But the one permanent and assured smooth treatment is that of temporal implants because of their shape and non-resorbable material composition. But temporal implants do require an incision to be placed over the main body of the temporalis muscle underneath the deep temporal fascia.
The location of the temporal implant incision is anywhere behind the temporal hairline. How far back one goes behind the temporal hairline does not matter but it is usually not further posterior than a vertical line drawn up from the ear. While the incision is usually fairly small and heals well it is still a potential scar concern when the the temporal hair density is thin or when the patient has a very close haircut or shaves their head.
The incisional concern for temporal implants is of particular relevance in men. This is because of their frequent close haircuts. Despite how well an incision can heal in the scalp, careful tissue handling that preserves the hair follicles and the smallest possible incision should be used. When looking at the size of temporal implants it may be daunting to think of a very small incision for insertion.
But the implant’s soft and very flexible quality makes it possible to fold the implant to allow it to pass through the skin incision. Once inside the subfascial pocket it can be unfold and positioned properly.
In the male temporal implant patient a small 2 cm skin incision can successfully used. Even with its small size it is important to place the incision parallel to the direction of exit of the hair follicles for the best scar camouflage. When so done the incisions can heal in a close to invisible manner as possible,
Dr. Barry Eppley