Complementary Strategies for Temporal Lifting Techniques: Biomechanical Insights From Combined Injection Techniques

Although the use of hyaluronic acid-based soft tissue fillers in the lateral facial region is known to have full-face aesthetic effects, systematic comparisons of injection techniques remain limited.

To compare the full-face effects of posterotemporal lifting alone and combined with supraperiosteal zygomatic arch injection, and to evaluate the use of images from three device types for aesthetic assessment.

Data from 20 female Asian patients (group A, 38.0 ± 6.29 years; group B, 41.5 ± 6.72 years) was analyzed retrospectively. Group A received single-point subcutaneous posterosuperior temporal injections, and group B additionally received supraperiosteal zygomatic arch injections. Outcomes were assessed using the Global Aesthetic Improvement Scale (GAIS) and three-dimensional (3D) quantifications of volume and vector changes in the medial (maxillary and medial mandibular regions) and lateral [temporal region (superolateral face) and lateral mandibular region (inferolateral face)] face. GAIS ratings of images obtained with three device types were compared.

Mean local (superolateral, inferolateral, and medial face) surface volume changes were 0.46 ± 0.36, 1.16 ± 1.03, and 0.03 ± 0.55 cubic centimeter (cm³), respectively, in group A, and 0.23 ± 0.38, -0.76 ± 0.96, and -0.37 ± 0.60 cm³, respectively, in group B. More vector displacement in the inferolateral and medial face was generally observed in group B. GAIS scores favored group B over group A, and 3D imaging over two-dimensional imaging.

Combined temporal lifting with supraperiosteal zygomatic arch injection may achieve better facial lifting effects than simple temporal lifting performed with the same filler volume.