Juhász Margit Lai Wun, Marmur Ellen S
Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Marmur Medical, New York, NY, USA.
J Cosmet Dermatol. 2015 Sep;14(3):254-9. doi: 10.1111/jocd.12155. Epub 2015 Jul 16.
Facial changes with aging include thinning of the epidermis, loss of skin elasticity, atrophy of muscle, and subcutaneous fat and bony changes, all which result in a loss of volume. As temporal bones become more concave, and the temporalis atrophies and the temporal fat pad decreases, volume loss leads to an undesirable, gaunt appearance. By altering the temporal fossa and upper face with hyaluronic acid filler, those whose specialty is injecting filler can achieve a balanced and more youthful facial structure. Many techniques have been described to inject filler into the fossa including a "fanned" pattern of injections, highly diluted filler injection, and the method we describe using a three-injection approach. Complications of filler in the temporal fossa include bruising, tenderness, swelling, Tyndall effect, overcorrection, and chewing discomfort. Although rare, more serious complications include infection, foreign body granuloma, intravascular necrosis, and blindness due to embolization into the ophthalmic artery. Using reversible hyaluronic acid fillers, hyaluronidase can be used to relieve any discomfort felt by the patient. Injectors must be aware of the complications that may occur and provide treatment readily to avoid morbidities associated with filler injection into this sensitive area.
面部衰老变化包括表皮变薄、皮肤弹性丧失、肌肉萎缩、皮下脂肪减少以及骨质改变，所有这些都会导致面部容量减少。随着颞骨变得更加凹陷，颞肌萎缩且颞脂肪垫减少，容量减少会导致面容憔悴，令人不满意。通过使用透明质酸填充剂改变颞窝和上半面部，擅长注射填充剂的人员可以实现面部结构更加平衡且年轻化。已经描述了许多将填充剂注入颞窝的技术，包括“扇形”注射模式、高度稀释填充剂注射以及我们所描述的三针法注射方法。颞窝填充剂的并发症包括瘀斑、压痛、肿胀、丁达尔效应、过度矫正和咀嚼不适。虽然罕见，但更严重的并发症包括感染、异物肉芽肿、血管内坏死以及因栓塞至眼动脉导致的失明。使用可降解的透明质酸填充剂时，可使用透明质酸酶缓解患者的任何不适。注射人员必须了解可能出现的并发症，并随时提供治疗，以避免与在这个敏感区域注射填充剂相关的不良后果。
