Temporal Shell Silastic Implants: Surgical Technique and Clinical Cosmetic Experience
Robert J. Troell, Barry L. EppleyIntroduction:
Loss of volume or hollowing occurs in the temporal fossa with aging. Volume replacement with fillers is the most common treatment option, but those requesting permanency may request temporal shell silastic implants.
Materials and Methods:
This study is a retrospective review of consecutive patients evaluating aesthetic permanent temporal fossa volume enhancement using temporal shell silastic implants with 2 different surface area coverages of differing thicknesses.
Methods:
Temporal shell silastic implant patients in 2 aesthetic practices were evaluated for aesthetic patient satisfaction, revision rates, and complications.
Results:
Seventy-nine patients (women 54, men 25) elected either a partial temporal fossa implant (type I, n = 29) or a complete fossa implant (extended or type II, n = 50). Implants were placed in subfascial temporalis plane with no implant fixation. The overall patient satisfaction rate for all permanent volume options was 93.4% using the Global Aesthetic Improvement Scale with very much improved or improved responses. There was very little swelling and rare bruising after the procedure. There were no medical complications. The overall complication rate related only to aesthetic concerns (13.9%), which encompassed asymmetry or implant size. The surgical revision rate was 7.6% due to too large or too small implant size or an asymmetry.
Conclusions:
Standard manufactured soft silicone solid temporal shell implants with 2 different surface area coverages and different thicknesses provide high patient satisfaction by a technically simple procedure with few side effects or complications and permanent results. Temporal shell implants are made of an ultrasoft solid silicone (flexible, smooth, safe), placed through a small incision behind the hairline with low visibility, and in the safe subfascial plane.