A technique for filling the temples with highly diluted hyaluronic acid: the "dilution solution".

ABSTRACT

BACKGROUND: Hollow temples are a common sign of aging, contributing to the upper face appearing "pinched" and the brows appearing short and ptotic. Many treatments have been described for this area, including fat injections and implants. However, traditional injection techniques have not proven entirely satisfactory in correcting the problem without resulting irregularities. OBJECTIVES: The author describes a technical refinement wherein diluted hyaluronic acid (HA) fillers are injected into the temple. METHODS: Thus far, a series of 40 patients has been treated over 18 months with the author's technique, which involves diluting the HA filler by a ratio of approximately two to one (diluent to filler) and injecting the temple as evenly as possible. As the saline component absorbs, the filling material is distributed more evenly in the temple than with undiluted filler. RESULTS: Patients experienced improved results, with a smoother appearance to the brow. There were no instances of complications requiring dissolution of the product with hyaluronidase. Irregularities proved minor and easily correctable; no intravascular complications were noted in this series of patients. Clinical photographs demonstrate improvement in the "pinched" upper face and an apparent elongation of the brows. The author estimates, based on prior experience, that duration of effect will be approximately two to three years. CONCLUSIONS: Dilution of the HA fillers administered for brow treatment results in a more even distribution of the product and a lower morbidity than previously described techniques, making temple treatment far easier than in the past.