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Aesthetic Correction Of Temporal Hollowing: A Review Of The Literature And A Novel Algorithm For Management
Henry M. Spinelli, MD, FACS, Jerry W. Chao, MD.
Weill Medical College of Cornell University, New York, NY, USA.

PURPOSE:
The temporal fossa is defined by bone and soft tissue. The hollowing deformity can arise from defects in bone and/or denervation, devascularization and wasting of the overlying muscle and fat pad. We present an algorithm to analyze and treat this common entity.
METHODS:
A retrospective review was performed of all patients treated for temporal hollowing over the past ten years. Data concerning aesthetic outcomes and complications was collected. A directed treatment algorithm replacing the affected structures using fillers, fat grafts, bone, soft tissue and alloplastic grafting was created.
RESULTS:
Based on our experience in treating over 150 surgical patients with temporal hollowing over a ten-year period, we have designed a paradigm based on the underlying etiology of the presentation. In a large and comprehensive series there were no major complications, and we had good to excellent correction of the deformity based on independent review of the results and MRI studies.
CONCLUSION:
We present an innovative algorithm which predictably corrects the temporal hollowing defect. The analysis and corrective methodology is easily learned and effectively applied by the average surgeon. Furthermore, our algorithm can be predictive and utilized in the primary treatment plan of craniofacial, skull base and wasting disorders cases obviating secondary correction. Analysis and treatment of the temporal hollowing deformity using our paradigm belongs in the armamentarium of all surgeons who see these deformities.


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