In short. A hollow temple can come from lost deep fat, from a recessed bony frame, or from a brow that has dropped. Only one of those is filler.
Key points
- Put a photograph from some years ago beside one taken today in the same light and from the same angle.
- If the temple is flatter but the brow tail sits where it always sat, the change is volume.
- If the brow tail has moved down and the hollow is deepest beneath it, the hollow is a shadow rather than a loss of tissue.
The temple is one of the first parts of the face to change and one of the last to be noticed. A hollow appears above the outer corner of the eye and beside the brow, and the upper face begins to look longer and narrower. The question worth settling first is what the hollow is made of, because the temple loses its fullness in three ways and only one of them is a volume problem.
Loss of the deep fat
The temple holds fat in compartments beneath the fascia that covers the temporalis muscle. This fat is lost with age and it is lost early, sometimes before the midface changes at all. What is left is a real deficit: the tissue over the bone is thinner than it was and the skin lies closer to the skull. This is the hollow that adding volume is designed for, and when it is the cause an old photograph usually shows the change clearly.
The frame beneath
Not every hollow is tissue that has gone. Some temples were always recessed because of the shape of the temporal fossa and the orbital rim around it. Where the bone is the reason, material placed in front of it changes the covering rather than the relationship, and the result is a fuller temple on the same frame. That is a real change and it may be the one you want, but it is a change to soft tissue and not to structure.
The brow and the cheek beside it
A temple can also read hollow because the structures around it have moved. When the lateral brow descends, the space beneath it looks deeper than it is. When the cheek loses support, the transition from the outer eye to the temple becomes a step rather than a slope. Filling the temple in either case adds volume to a face whose problem is position, and it produces a fuller upper face without changing the shape that bothered you.
A test with two photographs
Put a photograph from some years ago beside one taken today in the same light and from the same angle. If the temple is flatter but the brow tail sits where it always sat, the change is volume. If the brow tail has moved down and the hollow is deepest beneath it, the hollow is a shadow rather than a loss of tissue.
Reasons to slow down
- The temple has looked this way for as long as you can remember, and old photographs show the same shape.
- The brow tail has moved down, and the hollow is deepest directly beneath it.
- Weight is still coming off, or an illness is still being treated.
What changes when the temple is filled, and what does not, is set out in What Temple Filler Changes in the Upper Face. Whether to have filler at all belongs to the dermal filler pages rather than to this site.
Frequently asked questions
How can I tell whether my temple hollow is lost tissue or a shadow?
Compare a photograph from some years ago with one taken today in the same light and from the same angle. If the temple is flatter than it was and the brow tail sits where it always sat, tissue has been lost. If the brow tail has moved down and the hollow is deepest directly beneath it, the hollow is a shadow and the brow is the problem.
Can a temple be hollow because of the bone rather than because of fat?
Yes, and it is common. Some faces have a recessed temporal fossa and a prominent orbital rim from the beginning, and the hollow is a feature of the skeleton rather than something that has been lost. Filling in front of that bone changes the covering, which may be exactly what you want, but it does not change the structure underneath.
What if my temple hollow appeared while I was ill or losing weight?
Then the cause is still active and the shape is still moving. Filling a temple during illness, during treatment or while weight is still coming off means treating a target that will not stay where it is, and the assessment belongs with whoever is managing the cause rather than with the contour.
Risks & Limitations
- The temple is crossed by named vessels in a small space: the superficial temporal artery and its branches, the vein known as the sentinel vein near the outer orbital rim, and the deep temporal vessels beneath the fascia. Material entering an artery can travel, and because the frontal branch of the superficial temporal artery communicates with the vessels around the eye, skin loss and — rarely — loss of vision are possible. This is time-critical rather than cosmetic.
- The temporal branch of the facial nerve crosses the same region on its way to the brow. If it is affected the brow will not lift on that side. Most such weakness improves over weeks to months, and a proportion does not recover fully, which is why the way the brow lifts is recorded before treatment rather than only examined afterwards.
- Deep placement beside the temporalis muscle is commonly followed by a dull pressure headache that settles over a day or two, and by an ache on opening the mouth wide or chewing hard. A headache that is severe, one-sided in a new way, or worsening after the first days is not ordinary recovery and should be assessed.
- Adding volume to the temple does not lift a brow that has descended. It fills the shadow beneath the brow tail and changes how the upper face reads, and the position of the brow is unchanged. Where the distance between brow and eye is the complaint, the answer is an operation rather than an injection.
- Swelling and bruising, firmness and small lumps in the first weeks, asymmetry, nodules and delayed inflammatory reactions can occur. Every result is temporary, the material is not fully cleared between sessions, and only the reversible class can be broken down at all.
When to Seek Care
- Any change in vision, including blurring or a patch of lost sight — seek emergency care immediately.
- Severe pain out of proportion to the injection, or pain that is worsening rather than settling.
- Skin turning white, grey, mottled or dusky anywhere near the treated temple, the forehead or the eye.
- A brow that will not lift on one side, or a headache that is severe or worsening after the first few days.
- Swelling that is increasing after the first few days rather than settling, or fever with spreading redness, warmth or discharge.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews
- Chinese Medical Association Plastic Surgery Branch — clinical guidance
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.