How it works
Everything starts with a consultation. Your doctor will listen to what you hope for, examine your temples in person, and assess how hollow they are, how thick the tissue is, and how balanced the two sides are, while also looking at the line from your forehead to the brow tail and cheekbone. Your doctor will also ask about your health history and any medicines you take. This is the time to be clear about your expectations and to agree together on the right approach for your face, whether fat grafting or a filler injection, along with how much volume makes sense for you.
There are a few things to prepare beforehand. You will be told to stop certain medicines that can cause bleeding, and to have any tests the chosen method calls for. With fat grafting, the procedure is often done under local anesthesia, which may be paired with light sedation to help you relax; this means the treated area is numbed while you stay awake. In some cases another form of anesthesia may be used. The exact type is your doctor's decision, based on your health and how much work is involved.
With fat grafting, your doctor first takes fat from a donor area, usually the abdomen or thigh, using a thin tube through a few very small incisions; this step is called liposuction. The harvested fat is processed and cleaned to keep the healthy tissue. Your doctor then places the prepared fat into the temple in many small layers, through a very fine needle or tube, shaping it gradually so the two sides look full and even. The temple has blood vessels and nerve branches sitting at different layers, so your doctor works carefully along the correct anatomical plane. Because some of the fat will be reabsorbed, your doctor often places a little more than the final amount you both expect to keep.
If you choose a filler injection instead of fat grafting, your doctor numbs the skin and then injects filler into the right layer of the temple to replace volume. This is a gentler procedure and usually does not need a donor area. With either method, the entry points or injection points are usually very small. The total time varies from one person to the next and by method.