Last updated: April 26, 2026
Temple hollowing is one of the most visible yet frequently overlooked signs of facial aging and volume loss. As FDA-approved treatment options expand and awareness grows, more patients are exploring temple augmentation to restore a balanced, youthful facial contour. This guide from Salisbury Plastic Surgery covers the causes of temple hollowing, the latest filler and fat grafting options, and what to expect from treatment.
What Is Temple Augmentation and Why Is It Getting More Attention?
Temple augmentation is a cosmetic procedure that restores volume to the temporal fossa – the naturally concave area between the forehead, eyebrow, and ear. Growing clinical recognition, recent FDA approvals for temple-specific fillers, and rising demand driven by weight-loss-related facial hollowing have brought this once-overlooked treatment into the spotlight in 2025 and 2026.
Two hyaluronic acid (HA) fillers now carry specific FDA approval for temple hollowing correction. Juvederm Voluma XC received approval in March 2024 as the first HA filler indicated for this area, followed by Restylane Contour in March 2026. These approvals reflect a broader shift toward recognizing the temples as a distinct treatment zone in facial rejuvenation, not just an afterthought to cheek and lip enhancement.
Demand is also being shaped by the widespread use of GLP-1 medications for weight loss. According to the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), 67% of facial plastic surgeons reported an increase in patients seeking treatment for rapid weight-loss-related facial volume loss in 2025, with an estimated 19% surge in facial treatments overall. The temples are among the areas most visibly affected by this trend.
What Is Temple Hollowing and What Does It Look Like?
Temple hollowing is characterized by a reduction of volume in the temporal fossa, which can result in a skeletonized look and contribute to an aged appearance. Visually, it presents as sunken or concave indentations on either side of the forehead, just behind the outer edge of the eyebrow and above the cheekbone.
This volume deficit creates shadows that make the face appear gaunt or angular. The underlying bone structure becomes more prominent, and the natural oval contour of the face narrows at the upper third. Many patients describe their face as looking “tired” or “drawn” before they identify temple hollowing as the specific concern.
Why Are More People Seeking Temple Treatments in 2025 and 2026?
Several converging factors explain the rising interest. The FDA approvals for Juvederm Voluma XC (2024) and Restylane Contour (2026) have legitimized temple augmentation as a validated treatment with clinical trial data behind it. Patients and providers now have more confidence in a procedure that was previously performed exclusively off-label.
The GLP-1 medication trend – sometimes called “Ozempic face” – has accelerated demand significantly. Rapid or significant weight loss depletes facial fat compartments, and the temples are among the first areas to show visible hollowing. The AAFPRS data showing 67% of surgeons encountering these patients underscores just how widespread this concern has become.
More broadly, the aesthetic industry is experiencing sustained growth. The International Society of Aesthetic Plastic Surgery (ISAPS) reported that global aesthetic procedures approached 38 million in 2024, a 40% increase from 2020. Patients increasingly understand that comprehensive facial rejuvenation means addressing volume loss across all zones – including the temples. This spring, as consultation season picks up ahead of summer, temple augmentation is a timely topic for patients planning their approach to facial renewal.
What Causes Temple Hollowing?
Temple hollowing results from the loss of soft tissue volume in the temporal fossa, driven primarily by aging, weight loss, genetics, and certain medical conditions. The temporal region contains fat, muscle, and fascia layers that diminish over time, revealing the underlying bony contour and creating a sunken appearance in the upper lateral face.
How Does Aging Affect the Temples?
Age-related temple hollowing involves three simultaneous processes. The temporal fat pad – a layer of fat beneath the skin in the temple region – gradually atrophies over time. The temporalis muscle, which lies beneath the fat pad, also wastes and thins. Additionally, bone resorption in the temporal fossa means the structural foundation itself recedes.
These changes often begin subtly in the 30s and 40s and become more pronounced with each decade. By the time patients reach their 50s and 60s, temple volume loss can be one of the most noticeable contributors to an aged facial appearance. This process is well documented in peer-reviewed anatomical studies examining age-related facial volume changes.
Can Weight Loss Cause Hollow Temples?
Yes. Rapid or significant weight loss depletes facial fat compartments throughout the face, and the temples are one of the most visibly affected areas. This connection has become especially relevant with the rise of GLP-1 medications like semaglutide (Ozempic, Wegovy) and tirzepatide.
The AAFPRS reported in 2025 that 67% of facial plastic surgeons have seen more patients seeking treatment for weight-loss-related facial volume loss, including hollowed cheeks and temples. For many of these patients, the body transformation they desired came with an unintended facial side effect that temple augmentation can address.
Are There Other Reasons Temples Can Look Hollow?
Beyond aging and weight loss, several additional factors contribute to temple hollowing:
- Genetics and naturally thin facial structure – some individuals have minimal temporal fat volume regardless of age
- Low body fat percentage – athletes and fitness-focused individuals may have prominent temporal hollowing
- Certain medical conditions or medications that affect fat distribution or muscle mass
- Post-surgical changes from previous facial or cranial procedures
Understanding the underlying cause helps guide treatment selection. For example, a patient with age-related atrophy across multiple facial compartments may benefit from a different approach than someone with isolated temple hollowing after weight loss.
What Are the FDA-Approved Filler Options for Temple Augmentation?
Two hyaluronic acid dermal fillers currently hold FDA approval specifically for the correction of temple hollowing in adults: Juvederm Voluma XC, approved in March 2024, and Restylane Contour, approved in March 2026. Both are HA-based fillers designed for deep injection to restore volume, lift, and contour the temporal fossa with clinically validated safety and efficacy data.
What Is Juvederm Voluma XC and How Does It Work for Temples?
Juvederm Voluma XC became the first and only HA dermal filler to receive U.S. FDA approval for temple hollowing in March 2024. The product uses a VYC-20L formulation specifically designed for deep, supraperiosteal injection – meaning it is placed directly above the bone surface to add structural volume and lift to the temple region.
Clinical trial data demonstrated strong results. In the pivotal study, 80.4% of patients treated with Juvederm Voluma XC achieved at least a 1-point improvement on the Allergan Temple Hollowing Scale at 3 months. At 13 months, 73.3% of patients maintained that improvement – indicating durable, lasting correction for most treated individuals.
Is Restylane Contour Also FDA-Approved for Temple Hollowing?
Yes. In March 2026, Restylane Contour received FDA approval as the second HA filler indicated for temple hollowing correction. Dr. Mark Nestor, M.D., Ph.D., a board-certified dermatologist and dermatologic surgeon at the Center for Clinical and Cosmetic Research, noted that “despite the temples playing an important role in maintaining a youthful, balanced appearance, they are often overlooked.” He added that this approval will “help deliver harmonious, natural-looking results across the midface and temples.”
Having two FDA-approved products gives providers and patients greater flexibility. Different filler formulations offer slightly different handling characteristics, and the option to choose between them allows for a more personalized approach based on individual anatomy and goals.
How Do Temple Fillers Compare to Off-Label Use of Other Products?
Before these FDA approvals, temple filler was performed off-label using various HA products originally approved for other facial areas. While off-label use is legal and common in aesthetic medicine, FDA-specific approval for temple hollowing provides important advantages:
- Clinical trial data demonstrating safety and efficacy in this precise anatomical region
- Standardized injection technique guidance based on study protocols
- Improved patient confidence knowing the product has been rigorously evaluated for their specific concern
For context, HA fillers remain one of the most widely used aesthetic treatments overall. The American Society of Plastic Surgeons reported 5.3 million HA filler treatments in the U.S. in 2024, reflecting widespread provider experience with these products across multiple facial zones.
Is Fat Grafting a Good Option for Temple Augmentation?
Fat grafting is a surgical alternative to fillers that uses a patient’s own harvested fat to restore temple volume. A 2024 systematic review of 719 patients found volume retention rates of 33 to 65% at follow-up periods ranging from 6 to 96 months, with high patient satisfaction and a favorable safety profile. Fat grafting is best suited for patients seeking longer-lasting results or those who prefer an autologous approach.
How Is Fat Grafting for Temples Performed?
The procedure involves two stages. First, fat is harvested via liposuction from a donor site – commonly the abdomen, thighs, or flanks. The harvested fat is then purified and processed to isolate viable fat cells. In the second stage, the processed fat is carefully injected into the temporal fossa using fine cannulas.
Because the procedure uses the patient’s own tissue, it is considered autologous – eliminating concerns about allergic reactions or foreign material rejection. Salisbury Plastic Surgery has extensive experience with advanced fat transfer techniques, including microfat grafting, which uses ultra-fine cannulas and carefully processed fat to restore volume with extraordinary precision in delicate facial areas like the temples.
How Long Do Fat Grafting Results Last in the Temples?
The 2024 systematic review published in PMC/NIH found volume retention rates of 33 to 65% at 6 to 96 months of follow-up. Some degree of fat resorption is expected in the months following treatment, and touch-up procedures may be needed to achieve the desired final result.
Globally, facial fat grafting reached 0.9 million procedures in 2024 – up 19.2% from the previous year according to ISAPS – reflecting growing surgeon and patient confidence in the technique for facial volume restoration, including temple augmentation.
What Are the Pros and Cons of Fat Grafting Versus Fillers for Temples?
The following table summarizes the key differences between temple fillers and fat grafting to help patients compare their options:
| Factor | Temple Fillers (HA) | Fat Grafting |
|---|---|---|
| Procedure type | In-office, non-surgical | Surgical (liposuction + injection) |
| Anesthesia | Topical or local | Local with sedation or general |
| Appointment duration | 15 – 30 minutes | 1 – 2 hours |
| Recovery time | Minimal (1 – 3 days) | 1 – 2 weeks |
| Result duration | Up to 13 months (STAT 2) | 33 – 65% retention at 6 – 96 months |
| Reversibility | Yes (hyaluronidase) | Not easily reversible |
| FDA approval for temples | Yes (2 approved products) | N/A (surgeon-dependent technique) |
| Additional benefit | No secondary procedure site | Donor site slimming from liposuction |
| Maintenance | Annual or every 12 – 18 months | Touch-up may be needed once |
What Should You Expect During a Temple Augmentation Procedure?
Temple augmentation with fillers is a brief, in-office procedure typically completed in 15 to 30 minutes, while fat grafting requires a surgical setting with 1 to 2 hours of procedure time. Both approaches begin with a thorough consultation where the provider assesses the degree of hollowing and discusses goals, anatomy, and the most appropriate treatment path.
What Happens During a Temple Filler Appointment?
The appointment begins with a consultation and assessment, often using a standardized hollowing scale to evaluate the degree of volume loss. After the treatment plan is established, a topical numbing cream or local anesthetic is applied to the temple area.
The filler is then injected supraperiosteally – placed deeply, directly above the bone surface – to add volume, lift, and contour the temple. Most patients require 1 to 3 syringes per side depending on the severity of hollowing. The entire injection process typically takes 15 to 30 minutes, and patients can usually return to normal activities the same day.
How Long Is Recovery After Temple Augmentation?
Recovery differs significantly between the two approaches:
- Fillers: Minimal downtime with possible swelling, mild bruising, and tenderness for a few days. Most patients return to their usual routine immediately or the next day. This makes spring an ideal time for treatment, as any minor side effects resolve well before summer plans.
- Fat grafting: Expect 1 to 2 weeks of more noticeable swelling and potential bruising at both the harvest and injection sites. Activity restrictions – including avoiding strenuous exercise – typically apply for the first 1 to 2 weeks.
When Will You See Results and How Long Do They Last?
With fillers, volume improvement is visible immediately after injection. Final results emerge once any swelling subsides, typically within 1 to 2 weeks. Based on FDA clinical trial data, 73.3% of patients maintained at least a 1-point improvement at 13 months after treatment with Juvederm Voluma XC.
With fat grafting, patients see initial fullness right away, but some volume decreases over the following 3 to 6 months as a portion of the transferred fat is naturally resorbed. Stable, long-term results typically establish by 6 months, with 33 to 65% volume retention based on the 2024 systematic review data.
What Are the Risks and Side Effects of Temple Augmentation?
Temple augmentation carries risks that vary by treatment method. Filler-based treatments have a well-established safety profile documented through FDA clinical trials, with most side effects being mild and temporary. Fat grafting carries additional surgical risks. In both cases, provider expertise and detailed anatomical knowledge are critical factors in minimizing complications.
What Are Common Side Effects of Temple Fillers?
The most frequently reported side effects from temple filler treatment include:
- Swelling at the injection site
- Bruising
- Tenderness or soreness
- Redness
These effects are generally mild and self-resolving within a few days. The FDA clinical trial for Juvederm Voluma XC in the temple area established a favorable safety profile, consistent with the known side-effect profile of HA fillers used in other facial zones.
Are There Serious Risks to Be Aware Of?
While rare, serious complications can occur. The temple area contains significant vasculature, including the superficial temporal artery and its branches. Vascular occlusion – where filler inadvertently enters or compresses a blood vessel – is the most serious potential risk of any facial filler injection. Other uncommon risks include infection, asymmetry, and nodule formation.
For fat grafting, additional surgical risks include bleeding, seroma formation, and complications at the donor site. Peer-reviewed research has found that HA filler injection between the superficial and deep temporal fasciae is “a highly effective and safe procedure” when performed by an experienced provider with thorough knowledge of temporal anatomy. This underscores why selecting a board-certified plastic surgeon matters significantly for temple treatments.
Who Is a Good Candidate for Temple Augmentation?
Good candidates for temple augmentation are adults with visible temporal hollowing who are in overall good health, have realistic expectations, and are seeking to restore volume to the upper lateral face. Candidates may include individuals experiencing age-related volume loss, post-weight-loss facial hollowing, or naturally thin temple contours that contribute to a gaunt or aged appearance.
What Signs Indicate You Could Benefit from Temple Augmentation?
Patients who may benefit from temple augmentation typically notice one or more of the following:
- Visible concavity or sunken appearance at the temples
- Shadowing in the temporal region that makes the face look hollow
- Loss of facial width and the natural oval contour of the upper face
- A skeletal or bony appearance above the cheekbones
- Asymmetry between the left and right temples
Patients who have experienced significant weight loss – including those using GLP-1 medications – those with age-related volume changes, and individuals with naturally thin temporal anatomy are among the most common candidates seen in clinical practice.
How Do You Choose Between Fillers and Fat Grafting?
The best approach depends on several individual factors. A consultation allows for a personalized recommendation, but the following considerations typically guide the decision:
| Consideration | Favors Fillers | Favors Fat Grafting |
|---|---|---|
| Desired longevity | Comfortable with annual maintenance | Prefers a longer-lasting solution |
| Surgical willingness | Prefers non-surgical approach | Open to a surgical procedure |
| Body contouring interest | Not seeking body changes | Interested in dual benefit (harvest site slimming) |
| Severity of hollowing | Mild to moderate | Moderate to severe |
| Budget approach | Lower upfront, recurring cost | Higher upfront, less frequent retreatment |
Why Does Choosing a Board-Certified Plastic Surgeon Matter for Temple Treatments?
The temporal region is anatomically complex. It contains multiple fascia layers, the temporalis muscle, the superficial temporal artery and vein, and branches of the facial nerve. Safe, effective temple augmentation requires precise knowledge of these structures and the skill to navigate them.
Peer-reviewed research confirms that proper technique – specifically injection between the correct fascia layers – is critical for both safety and optimal results. Board-certified plastic surgeons like Dr. Deborah Ekstrom at Salisbury Plastic Surgery have undergone rigorous training in facial anatomy, surgical technique, and injectable treatments. This level of expertise is essential for achieving natural-looking temple restoration while minimizing risk.
Frequently Asked Questions About Temple Augmentation
How Much Does Temple Augmentation Cost?
Temple augmentation costs vary based on the provider, geographic location, product used, and the amount of correction needed. Filler costs are typically calculated per syringe, and most patients require 1 to 3 syringes per side. Fat grafting involves additional surgical facility and anesthesia fees, resulting in a higher upfront cost. Cosmetic procedures are typically not covered by insurance. A consultation provides the most accurate cost estimate based on individual needs.
Does Temple Filler Hurt?
Most patients report mild pressure or discomfort rather than significant pain. Topical anesthetic cream and/or local anesthesia are applied before treatment. Juvederm Voluma XC also contains lidocaine within its formulation, which helps numb the area during injection. Fat grafting is performed under anesthesia, so patients do not experience pain during the procedure itself.
Can Temple Filler Be Dissolved If You Don’t Like the Results?
Yes. Hyaluronic acid fillers can be dissolved using an enzyme called hyaluronidase, which breaks down the HA gel. This reversibility is an important safety advantage of HA-based temple fillers. If a patient is dissatisfied with the result or if a complication arises, the filler can be partially or fully dissolved. Fat grafting results are not easily reversible, which is an important consideration when choosing between the two approaches.
Can Temple Augmentation Be Combined with Other Facial Procedures?
Temple augmentation is frequently combined with other facial treatments as part of a comprehensive volumization strategy. Common combination treatments include cheek filler, jawline contouring, under-eye hollowing correction, brow lift, and facelift procedures. The goal of combining treatments is to achieve what Dr. Nestor described as “harmonious, natural-looking results across the midface and temples” rather than addressing one area in isolation.
How Often Do You Need to Repeat Temple Filler Treatments?
Based on FDA clinical trial data, 73.3% of patients maintained improvement at 13 months after treatment with Juvederm Voluma XC. Most patients return for maintenance treatments annually or every 12 to 18 months. Some clinical evidence suggests that repeated filler treatments may require less product over time, as the filler stimulates some degree of collagen remodeling in the treated area.
What Is the Next Step If You’re Considering Temple Augmentation?
Temple hollowing is a treatable concern with both non-surgical and surgical solutions backed by clinical evidence. With two FDA-approved fillers now available and fat grafting supported by peer-reviewed research, patients have more validated options than ever before. The right approach depends on individual anatomy, goals, lifestyle, and the severity of volume loss.
A personalized consultation is the most important step in determining which treatment is appropriate. Dr. Deborah Ekstrom and the team at Salisbury Plastic Surgery are experienced in both injectable and surgical approaches to temple augmentation and can help you evaluate your options based on your specific needs. If you are noticing temple hollowing and considering treatment this spring, reaching out to schedule a consultation is the best way to get answers tailored to your face and your goals.
Frequently Asked Questions
What causes temple hollowing?
Temple hollowing is caused by a loss of soft tissue volume in the temporal fossa, driven primarily by aging, weight loss, genetics, and certain medical conditions. As people age, the temporal fat pad shrinks, the temporalis muscle thins, and the underlying bone recedes. Rapid weight loss – including from GLP-1 medications like semaglutide – also depletes facial fat compartments, with the temples among the first areas visibly affected.
What are the FDA-approved fillers for temple augmentation?
Two hyaluronic acid fillers currently hold FDA approval specifically for temple hollowing correction: Juvederm Voluma XC, approved in March 2024, and Restylane Contour, approved in March 2026. Both are designed for deep, supraperiosteal injection directly above the bone surface to restore volume and contour. These approvals provide clinical trial data supporting safety and efficacy for this specific treatment area.
How long do temple filler results last?
Temple filler results with Juvederm Voluma XC last up to 13 months or longer for most patients. In FDA clinical trials, 80.4% of patients achieved at least a 1-point improvement at 3 months, and 73.3% maintained that improvement at 13 months. Most patients schedule maintenance treatments annually or every 12 to 18 months to sustain their results.
What is the difference between temple fillers and fat grafting?
Temple fillers are non-surgical, in-office treatments completed in 15 to 30 minutes with minimal downtime and results lasting up to 13 months. Fat grafting is a surgical procedure that harvests the patient’s own fat via liposuction and injects it into the temples, with volume retention rates of 33 to 65% at 6 to 96 months. Fillers are reversible with hyaluronidase, while fat grafting is not easily reversed.
Does temple filler hurt?
Most patients report mild pressure or discomfort rather than significant pain during temple filler injections. Providers apply topical numbing cream or local anesthesia before treatment, and Juvederm Voluma XC contains lidocaine within its formulation to help numb the area during injection. The entire procedure typically takes 15 to 30 minutes, and patients can usually return to normal activities the same day.
Can temple filler be dissolved if you are not happy with the results?
Yes, hyaluronic acid temple fillers can be dissolved using an enzyme called hyaluronidase, which breaks down the filler gel. This reversibility is an important safety advantage of HA-based fillers. If a patient is dissatisfied with the outcome or a complication develops, the filler can be partially or fully dissolved. Fat grafting results, by contrast, are not easily reversible.
Who is a good candidate for temple augmentation?
Good candidates for temple augmentation are adults with visible temporal hollowing who are in overall good health and have realistic expectations. Common candidates include individuals experiencing age-related volume loss, facial hollowing after significant weight loss – including from GLP-1 medications – or naturally thin temple contours that create a gaunt or skeletal appearance in the upper face.
