Abstract

Background: The aging face often exhibits volume loss, particularly in the temporal region, where the presence of complex neurovascular structures like the superficial temporal artery increases the risk associated with rejuvenation procedures. Hyaluronic acid fillers are extensively utilized to address these concerns, albeit requiring precise techniques to avoid vascular complications.
Methods: This case study involved two Caucasian female patients, aged 41 and 37, who underwent temporal augmentation using HA fillers to correct hollowness and enhance facial contours. Ultrasound mapping of the superficial temporal artery (STA) was performed to guide the injection process. A total of 2.4 mL of HA filler was administered to each patient using a 25G, 50mm blunt cannula under real-time ultrasound guidance.
Results: The application of HA filler using the DOMINO lateral lifting technique not only restored volume but also provided a lifting effect on the medial and lower thirds of the face. Ultrasound guidance facilitated precise cannula placement within the interfascial space, ensuring the avoidance of vascular injury, with no post-procedural complications such as hematoma or intravascular filler placment observed.
Conclusions: Ultrasound-guided HA filler injections in the temporal region provide a safe and effective method for facial rejuvenation. This case highlights the importance of precise anatomical mapping and real-time procedural guidance to enhance safety and aesthetic outcomes. Future research with a larger cohort is recommended to further validate these findings.

Keywords

domino effect, hyaluronic acid fillers, temples, cannula, ultrasound mapping, superficial temporal artery