Temporal Filling and Facial Lifting: Rethinking Expectations

Temporal lifting using injectable fillers has gained considerable attention in facial esthetics, based on the anatomical principle that strategic volumization can produce lifting effects through mechanical transmission of forces. However, there is a significant gap between anatomical plausibility and clinical evidence. To conduct a scoping review of the literature examining the evidence supporting temporal lifting and to explore the discrepancy between anatomical theory and measurable clinical results. A search of the PubMed and MEDLINE databases was conducted using terms such as "temporal lifting," "temporal filler," and "fascial lifting." Clinical studies and case series that evaluated the mechanical or clinical effects of injections in the temporal region were included. Although cadaveric studies provide robust theoretical support for force transmission through fascial continuity, clinical validation reveals substantial limitations. Prospective studies demonstrated minimal tissue displacement (0.13 mm) despite high patient satisfaction, suggesting expectation bias. A recent randomized clinical trial employing automated stereophotogrammetry found insignificant displacement (< 0.7 mm) and null GAIS scores. In contrast, another RCT reported more pronounced lifting effects using extended techniques and combined injections, although methodological and volume differences may justify the divergent results. The primary outcome of temporal injections is local volumetric restoration rather than true lifting. Clinicians should emphasize the predictable benefits of volumization, presenting any lifting effect as a possible secondary benefit of variable magnitude. Although temporal lifting possesses anatomical plausibility, clinical evidence does not always support lifting effects when standard volumes are used. The persistent gap between subjective clinical impressions and objective measurements underscores the importance of methodological rigor in validating anatomical concepts.