Temporal Filling and Facial Lifting: Rethinking Expectations

Area of Science:

• Facial aesthetics
• Anatomy
• Injectable fillers

Background:

• Injectable fillers for temporal lifting are popular in facial aesthetics.
• Anatomical principles suggest strategic volumization can create lifting effects via force transmission.
• A gap exists between anatomical theory and clinical evidence for temporal lifting.

Purpose of the Study:

• To conduct a scoping review of literature on temporal lifting evidence.
• To explore discrepancies between anatomical theory and clinical results.
• To evaluate the mechanical and clinical effects of temporal injections.

Main Methods:

• Searched PubMed and MEDLINE for "temporal lifting," "temporal filler," and "fascial lifting."
• Included clinical studies and case series evaluating temporal injection effects.
• Reviewed cadaveric studies, prospective studies, and randomized clinical trials (RCTs).

Main Results:

• Cadaveric studies support force transmission, but clinical validation shows limitations.
• Prospective studies showed minimal tissue displacement (0.13 mm) with high patient satisfaction, suggesting expectation bias.
• RCTs reported insignificant displacement (<0.7 mm) or variable lifting effects depending on techniques and volume, with volumization being the primary outcome.

Conclusions:

• Temporal lifting has anatomical plausibility, but clinical evidence for significant lifting is limited with standard volumes.
• The primary outcome of temporal injections is local volumetric restoration, not true lifting.
• Clinicians should manage expectations, highlighting volumization as the predictable benefit and lifting as a variable secondary effect.