Treacherous territory: Temple fillers and tissue necrosis

Temporal region of the face is considered the most promising facial region for inducing panfacial effects, playing an increasingly important role in facial contouring and rejuvenation surgeries, which in turn has led to a rapid growth in the demand for aesthetic correction for temporal hollowing. In order to correct this issue and achieve a more youthful appearance, filler injections can be used. Although this procedure is generally safe and is increasingly popular, complications may happen. Complications include visual loss, neurological deficits, embolism, and non-thrombotic pulmonary embolism. These complications are thought to result from injection of filler material into facial arteries and veins. We describe here a patient who developed pain in the parieto-temporal region following hyaluronic acid (HA) injection for temporal augmentation, which was complicated by tissue necrosis and alopecia. This was managed with hyaluronidase injection and aspirin tablets. Patient was followed for 6 months period after which she had complete hair growth and total resolution of skin necrosis without any scar formation. Since complications of HA injection are wide and serious, practitioners should always be aware of potential consequences of such procedures.