Ideal anatomy and proportions:
A young and aesthetic forehead is round with, for women, a supra-brow depression (above the orbital rim) that is not very marked. The temples are an important element in the aesthetics of the forehead, they can become hollow with time due to a loss of the fat and a thinning of the temporal muscle, thus creating a hollow area in front of the temples. Hollow temples can be corrected by injection of hyaluronic acid (filler) or lipofilling (fat itransfer) in order to re-establish a temple bulge harmonious with the forehead.
Technique :
Hyaluronic acid: entry point (<1 mm at the hairline), then filling: in general, it takes to 1.5 to 2 ml per side.
Lipofilling: fat removal (often inner knee or abdomen) under local anesthesia (no pain with an appropriate anesthesia), decantation and specific preparation of the fat (thus recovering part of the purified fat, rich in stem cells) and then reinjection by the same technique as hyaluronic acid.
Results :
Time to final results:
Hyaluronic acid: immediate
Lipofilling: 1 week for the filling, but 3 months for the rejuvenation effect on the skin of the stem cells contained in the fat
Longevity of results :
Hyaluronic acid: 6-12 months
Lipofilling: 5-10 years
Before injection:
Stop smoking 1 month before lipofilling
Do not take Aspirin 10 days before surgery, inform Dr. Lucas of any anticoagulant medication (Sintrom, Coumadin, Eliquis, etc.) to arrange for its discontinuation or replacement.
Take Arnica capsules 5 times a day for 5 days before surgery to prevent hematoma.
Contraindications hyaluronic acid: autoimmune diseases, pregnancy, breastfeeding
Procedure :
Pain: the pain during the intervention will be almost non-existent, with an adapted anesthesia
Duration of the procedure: 30 minutes for hyaluronic acid, 60 minutes for lipofilling
Anesthesia: local
Location: office for hyaluronic acid, operating room for lipofilling
Ambulatory (without hospitalization)
After injection:
Post-operative pain: 1/10 often responding to Dafalgan
Social eviction:
Hyaluronic acid: no (discrete swelling for 24-48h)
Lipofilling: swelling and hematoma for 4-7 days
Sutures removal: no sutures
Return to work: immediate for hyaluronic acid, 2-3 days for lipofilling
Resumption of sports: 24 hours for hyaluronic acid, 2-3 days for lipofilling
Instructions:
Bed rest without major effort and ice mask for 2-3 days, as often as possible, to reduce swelling.
Do not compress the fat injection area if lipofilling (risk of fat loss)
Take Arnica capsules 5 times a day for 5 days after surgery to prevent hematoma
Stop smoking permanently to prevent fat and hyaluronic acid resorption
Hyaluronic acid:
Control Dr Lucas 2 weeks
Lipofilling :
Check-up by Dr Lucas 2 weeks, 3 months
Complications common to all injections:
– Infection, hematoma, asymmetry, under or overcorrection
– Intravascular emboli: it is important to have this procedure performed by a qualified physician who is used to injecting this area, which is richly vascularized with a very variable vessel anatomy. A vascular embolus if it moves into the circulation of the retina can lead to blindness or necrosis.
Alternatives and operations that can be combined:
Global rejuvenation of the eye: this operation can be combined with blepharoplasty, a filling of the dark circles which are sometimes hollow or a brow lift
Lipofilling of the temples can also be combined with lipoflling of the forehead (in order to re-establish a round forehead) and lipofilling of the supra-brow depressions (hollows above the orbital rim) in order to soften or feminize the face.
