Aging of the temples: loss of volume and bone
- Nerve
- Highlighted area
Quick facts
- What happens
- The temporal fossa hollows from loss of fat, muscle and bone, and the face takes on a gaunt or tired look.
- Structures involved
- Skin, temporal fat pad, fasciae, temporalis muscle, bone and vessels.
- Central risk
- A high vascular risk area, with temporal arteries and anastomoses with the ocular circulation.
- Role in reading the face
- A hollow temple accentuates the zygomatic bone and the superciliary arch, making the midface look wider and the upper face narrower.
The temple is one of the areas that change most with age and that get the least attention in the patient's concerns. Patients talk about dark circles, cheeks and tired eyes, and rarely about the "temple". Yet when it hollows, the upper third loses width, the zygomatic bone stands out and the face looks thinner and harder. Looking at the temple is often looking at the cause of a concern that shows up somewhere else.
This page is a review of aging in the temporal area, with no injection technique. The goal is to organize the assessment. The approach rests with the qualified professional, in line with the rules of their professional council in Brazil and the product label.
What is in the temple?
The temporal area has well-defined layers, and knowing them helps explain what changed.
| Layer | What it is | What happens with age |
|---|---|---|
| Skin | Thin and mobile | Loses elasticity and thickness |
| Subcutaneous tissue | Little fat | Atrophy |
| Temporoparietal fascia | Superficial fibrous layer | May loosen |
| Deep temporal fascia | Layer covering the muscle | Stays firm, divides the area |
| Temporal fat pad | Deep fat | Loses volume |
| Temporalis muscle | Chewing muscle | May atrophy |
| Bone of the temporal fossa | Bony base | Remodels and resorbs |
The important vessels in the area include the superficial temporal artery, the middle temporal artery and veins of variable caliber. The full anatomy for safety purposes is in temporal anatomy for injectables.
What explains the hollowing?
Temporal hollowing has several causes, which add up.
- Loss of deep fat, which no longer fills the space between the muscle and the fascia.
- Atrophy of the temporalis muscle, seen with age, in people who chew little or in treatments that reduce muscle activity.
- Bone resorption, which deepens the concavity of the fossa.
- Weight loss, which reduces volume quickly and can surprise the patient.
- Skin laxity, which emphasizes shadows.
- Genetic factors, which determine whether the temple is naturally flat or concave.
When the temple hollows, the zygomatic arch and the superciliary arch look more prominent, the face looks more angular, and the transition to the cheek loses smoothness. The effect is an "apparent skeleton". For the general context, see facial aging by layers and facial volume loss after weight loss.
How to assess
The assessment should be done from the front, the profile and the three-quarter view, under diffuse light, and also with palpation.
Check whether the patient has hypertrophy of the temporalis muscle, common in bruxism, which can mask the concavity at rest and reveal it after the muscle is treated. See botulinum toxin for bruxism.
Vascular risk in the area
The temple is considered a high-risk area. The temporal arteries anastomose with branches of the ophthalmic circulation, and the veins in the area can be superficial and fragile. Vascular complications, although rare, can have serious consequences, including visual ones.
Another possible complication in the area is the Tyndall effect, in thin skin. See Tyndall effect in the forehead and temples.
What usually enters the discussion
The table is a map of categories discussed in the literature, not a protocol.
| Goal | Categories discussed | Note |
|---|---|---|
| Restore deep volume | Fillers and biostimulators | Require careful assessment and a qualified professional |
| Improve skin quality | Biostimulation | Variable result |
| Correct asymmetry | Individual planning | May require more than one session |
| Investigate the cause | Clinical assessment, weight, habits | Before any procedure |
For biostimulators, see biostimulator in the temples. The choice of product and technique rests with the professional.
How to talk to the patient
Avoid promising rejuvenation. Talk about balance, softening and follow-up. Agree on a review and explain that the result is temporary.
Test your review
Temple and other areas of the upper third
The temple does not age alone. The forehead, eyebrow and orbit change along with it, and reading the whole shows whether the temple is the protagonist or a supporting player. A hollow temple can accentuate the tired-eyes look and the shadow at the outer corner of the eye, and the concern of a "heavy eyelid" sometimes improves when the lateral contour is rebalanced.
So, when planning the upper third, start with the general reading instead of going straight to the spot the patient points to. See aging of the forehead and eyebrow and periorbital aging. In faces to be treated in stages, the temple is usually discussed together with the cheekbone.
Documenting the temple
The temple is hard to photograph well, because the shadow changes a lot with light. Use diffuse light, keep the same distance and angle, and photograph from the front, the profile and the three-quarter view, with the head in the horizontal plane. Note the date, the side and the patient's position in the record.
Also record what the patient says about the area, in their own words. Often they do not mention the temple and talk about a "thin face" or "bone showing". This helps link the concern to the anatomy, and later show what changed or did not change. Good documentation is the professional's defense against dissatisfaction, and the basis of any honest comparison.
In summary
Temple hollowing results from loss of fat, muscle and bone, and changes how the whole upper and middle third reads. Careful assessment, respect for vascular risk and an honest conversation about expectations make it possible to decide whether there is an indication and how to follow up. Without a clear concern, the most prudent course is usually to observe.
Frequently asked questions
Why does the temple hollow with age?
Because the fat pad, muscle and bone of the area lose volume, and the skin loses support. The combination creates a concavity that can be subtle or obvious, depending on the person.
Does a hollow temple make the face look older?
It tends to contribute to a tired or thin look, and accentuates the contour of the zygomatic bone. Reading the face as a whole, however, matters more than reading one isolated area.
Is filling the temple risky?
It is a vascular-risk area, with important arteries and veins. Complications are rare but can be serious, and hyaluronidase must be available when hyaluronic acid is used.
Does weight loss affect the temple?
Yes. Weight loss reduces the fat in the area and accentuates the concavity, and recovering the volume can be harder after large changes.
Harmy images are illustrative simulations generated by AI from the patient's photo to support the conversation between practitioner and patient. They are not a promise of results. Indication, technique, product and volume are solely the decision of the licensed practitioner. This content is for information only and does not replace a clinical assessment.