The temples are among our most unassuming features. We don’t adorn them with makeup, target them with special serums, or pierce them as a rite of passage or act of rebellion. We don’t think about them much at all, really—until one day, we do.
We typically take notice as they start to shrink, altering their surroundings. Like the rest of the face, the temples deflate with age, losing volume as resident fat pads, collagen, and bone gradually erode. Since there’s already a natural concavity to the temples—actual hollows in the skull itself—you may see this area sinking faster than other parts of the face, says Dr. Papri Sarkar, a board-certified dermatologist in Brookline, Massachusetts.
Sunken temples can exacerbate crow’s-feet, make the brow look heavy, and even change the shape of the face, giving it a peanut-shell silhouette. “If you look at children, the forehead is very broad and the rest of the face is plump with healthy facial fat,” explains Dr. Jennifer MacGregor, a board-certified dermatologist in New York City. Aesthetics doctors often liken a youthful face to an upside-down triangle—but receding temples upend that geometry: “The upper face narrows and the [overlying] skin drops, causing the lower face to sag and widen,” she adds.
Oftentimes, it’s the consequences of temple atrophy—not the hollows themselves—that catch our eye. “People notice the lower face softening and drooping but almost never put their finger on the cause,” Dr. MacGregor says. Likewise, Dr. Sarkar finds it’s rare for patients to come in asking for temple filler specifically, but many do recognize an overall shape shift—the peanut-head phenomenon that’s synonymous with temple hollowing.
Perhaps more striking than this new contour is what it conveys. “People subconsciously read faces—we make quick judgements on age just by reading head shape across the room, well before we get close enough to see any wrinkles,” says Dr. Annie Chiu, a board-certified dermatologist in Redondo Beach, California. “A gaunt, depressed temple creates a concave area that sucks in light, making the face appear more shadowy, less healthy.” Moreover, she adds, as the temples collapse, the cheekbones become exaggerated, the outer eyelids droop, and the tails of the brows “appear to fall off a ledge, leading to a sharpness in this area.”
Injectable fillers—both hyaluronic acid fillers and non-HA volumizers—can restore temples to their former proportions, softening the face and promoting a more youthful appearance in the most discreet way. But “the temples are not well understood as a critical area to treat, particularly among newcomers to dermal filler injections,” Dr. Chiu tells us. Here, 10 things to know about this influential area before going under the needle for rejuvenation.
1. Certain people are more prone to temple hollowing
The temporal fat pad “is very sensitive to cardiovascular activity,” notes Dr. Sarkar. “Patients who are seriously athletic or work out a ton tend to lose a lot of fat there as well as in the cheek hollows and marionette area.” When these spots wane in unison, the face turns skeletal. The effect is especially harsh in someone with naturally prominent cheekbones or a glut of cheek filler: the deficits directly above and below those high points can give the face an angular and “ungenerous” Maleficent vibe, Dr. Sarkar says, which can be quite aging.
2. Filling the temples adds a subtle youthfulness to the face
“Our eyes perceive things that are round as younger,” Dr. Sarkar goes on to say. Again, picture a child’s face. “When we say someone has ‘lost their baby fat,’ we’re largely looking at their temples and cheeks.” Filling the temples restores those curves to an extent, she adds, “making people look friendlier and more approachable.”
According to Dr. Chiu, this is “an incredibly impactful area to rejuvenate, as it also softens the sharpness of the lateral forehead and brings balance to the midface” by blurring the bony borders between temples and cheeks and creating a soft, flowing, crescent-shaped contour that catches the light and brightens the whole face, she says.
For some, temple filler can influence the hairline in the area, coaxing it forward a bit. “My patients with really hollow temples, they don’t even realize it, but they stop pulling their hair up, because they don’t feel like it looks attractive anymore,” Dr. Chiu says. But as the temples swell slightly, the neighboring hairline creeps forward, giving a more youthful look—and expanding styling options.
While the overall improvement can be wowing to patients, “no one else can tell exactly what it is that makes the person look softer, brighter, and more lifted,” adds Dr. Chiu. The temples are “probably one of the sneakiest areas [we can treat] without anyone suspecting.”
3. Temple filler isn’t for everyone
We’re making temple filler sound like some secret, magical fix with untold face-illuminating, age-defying, eye-elevating perks—and it absolutely can be. But unlike, say, lip filler (in its infinite iterations), this isn’t a prime injection site for everyone. Those with round faces aren’t likely to benefit—in fact, plumping the temples can do these folks a disservice. A natural hollowing of the temples “actually makes full faces look a little slimmer and more svelte by accentuating the cheekbones,” says Dr. Sarkar. “They need that concavity at the temples to balance the roundness of the face.”
4. Temple injections can feel pretty weird
Without a doubt, “filler in the temple region feels strange,” says Dr. MacGregor. While the injection isn’t painful per se, you may “feel more annoying pressure and can sometimes hear a crunchy or crackly sound effect.” Depending on their preference, injectors may use a needle or cannula to fill the temples (more on that coming up). Dr. Sarkar finds that not everyone can tolerate the feeling of the cannula sliding under the skin of the temples. “This area can be harder to traverse than other spots, so you may sense more pushing and pulling [despite sufficient numbing],” she says. “The feeling of the cannula here just really bothers some people.”
5. The temples are a danger zone
While no area of the face is 100% safe to inject, certain areas are riskier than others, due to the vasculature of the region. Injecting filler into a facial artery can restrict blood flow to the skin or, in some cases, the eyes, leading to necrosis (skin death) and permanent blindness.
The temples are considered high-risk for filler complications. “The superficial temporal artery is an end artery, and accidental injection into this artery can lead to compromise of blood supply to certain parts of the forehead,” explains Dr. Chiu. “A more concerning risk is that certain blood vessels in the temple can have a connection with vessels that feed the retina”—meaning that there’s a chance of vision loss too.
It’s super important that your injector understands temple anatomy and knows to target specific planes, placing filler only at safe depths, where there are no vessels. In the temples, this means injecting either superficially (usually with a cannula) or going deep on bone with a needle. Doctors may vary their tool and injection technique, based on your anatomy (the thinness of your skin, the extent of your hollowing), their comfort level, and the type of filler they’re using.
6. There is no one best filler for the temple area
The doctors we interviewed use all manner of filler in the temples—various HA fillers, Sculptra, and Radiesse, sometimes in combination. The latter two are more proficient at jump-starting collagen production and tend to deliver longer-lasting results—but unlike HA, they’re not reversible with hyaluronidase, so injecting them safely requires above-average skill and expertise.
For most patients with temporal volume loss, Dr. Sarkar frequently leans on Sculptra or dilute Radiesse, finding they give a more natural finish than HA—both in the short term and down the line. “You have to think about how the product is going to look, not only when you’re done injecting but also as it’s wearing off, months later,” she says. In her experience, Sculptra and Radiesse tend to wear more evenly than HAs, which can sometimes degrade less uniformly, resulting in a lumpy look as they fade. On occasion, when she does use HA in the temples, she places it deep so “you’re less apt to see any lumps or dimples as it’s breaking down.”
There is no one-size-fits-all approach to the temples, however. Dr. MacGregor prefers injecting filler deep so it’s “hidden beneath the smooth contour of the temporalis muscle,” she says. Dr. Chiu finds that layering Sculptra under Radiesse often gives the most dramatic and durable correction in this area.
7. The temples rarely get a stand-alone shot
“It’s very unusual that we just do temple filler and call it a day,” says Dr. Sarkar. “If you have a lot of temple hollowing, then odds are, your lower face has likely crumbled even more than your upper face.” To avoid an obvious mismatch and restore a sense of balance, “we have to make it look like the same aging process has hit the whole face.” And the best injectors do this by assessing and addressing the face holistically rather than spot-treating with filler.
The injections that best complement temple filler will vary from patient to patient. Dr. Sarkar commonly treats the cheek hollows, the lips, and the marionette area at the same time as the temples. Dr. MacGregor likes to add structure to the cheeks (if needed), the area in front of the ears, the pyriform space (at the top of the nasolabial folds), and the chin when filling temples.
All of our doctors stress the importance of balancing the cheeks and the temples. People tend to get carried away with cheek filler, Dr. Sarkar says, because it’s such a “bang-for-buck area” and can give the illusion of lift. Plus cheek filler is often a gateway injection for first-timers—and top-offs quickly become a routine cosmetic procedure. But if you continue to augment the cheeks while ignoring the temples, adds Dr. Sarkar, “things can start to look really abnormal after a while.”
8. You can overfill the temples—and it’s not a good look
While our doctors say it’s rare to make the temples look overdone, especially when placing filler deep, it’s certainly not impossible. And when it happens, “people appear angry and lionlike—it’s an aggressive look,” says Dr. Sarkar. In her opinion, overfilled temples are often a by-product of injectors going too far in attempting to smooth adjacent crow’s-feet or visibly “lift” the brow by repeatedly pouring filler into the temples.
When the right amount of filler is injected with appropriate intentions, adds Dr. Chiu, “temple filler is almost always very natural looking and just softens the contour of the lateral face.”
@medicaljasthetics How filler in the temples is the most slept on area #filler #injectables #antiaging #dermalfillers ♬ Lost – Album Version – Frank Ocean
9. Jaw pain is common following temple filler injections
If you’ve ever had your temples filled, you probably discovered that the treatment comes with a surprise side effect: jaw soreness. The temporal muscle works in conjunction with the masseter muscle (of the jaw) to open and close the mouth. Injecting deep into the temple “can cause temporary pressure on the temporal-mandibular joint, leaving it achy and making it hard to open your mouth for the first day or so,” cautions Dr. Chiu. “Once any swelling decreases, these symptoms resolve fairly quickly.” Intermittent icing along the jawline can help speed the process.
Dr. Sarkar points out that there is also an abundance of nerves in the temples, which gets activated with injections (of any kind) and subsequent swelling. They don’t necessarily trigger pain, but you may feel some slight throbbing or twinges following temple filler. This is generally normal, but if it persists or presents as unrelenting or disproportionate pain, call your injector.
10. Temple filler treatment is pricey—but usually worth it
Given the broad expanse and the large loss of volume that’s typical of the temples, filling this area can be a big investment. “Almost everyone needs two syringes of any sort of filler, to make a difference,” says Dr. Chiu. (Which means you’re talking at least a grand, if not more, to tackle just this one area.) Since the temples aren’t as front and center as, say, the lips or tear troughs, patients are sometimes hesitant to spend on this area. Still, she says, “once they’re educated on temple filler and see the transformation, they realize it’s such an important factor in presenting a youthful, balanced, and healthy face shape.”
