Temple Filler

Temple filler is an injectable treatment that uses hyaluronic acid based dermal filler to restore the volume that has been lost in the temple region. The filler is placed beneath the skin, above or around the temporalis muscle, to recreate the smooth, full contour that the temples naturally have in a youthful face.

The fillers used for the temples are carefully selected for this specific area. Depending on the degree of hollowing and the patient's anatomy, Dr Karwal may use a low to medium density filler that integrates smoothly with the thin tissue of the temple region. The product needs to provide enough volume to restore the contour without feeling hard, looking lumpy, or creating an unnatural fullness.

Hyaluronic acid is the same substance used in fillers throughout the face. It's naturally occurring in the body, fully biocompatible, and temporary. It attracts and retains moisture, which means it not only adds volume but also improves the hydration and quality of the overlying skin. If for any reason you're unhappy with the result, it can be dissolved using hyaluronidase.

The impact of temple filler is often far greater than patients expect, precisely because they didn't realise how much the hollow temples were affecting their overall appearance.

Restoring volume to the temples recreates the smooth, convex contour of the upper face. This immediately makes the face look fuller, healthier, and more youthful. The gaunt, skeletal quality that hollow temples create is replaced with a softer, more balanced appearance.

The face shape often improves dramatically. When the temples are full, the upper face widens to match the lower face, restoring the oval or heart shaped proportions that are associated with youth. The bottom heavy, pear shaped look that develops with temple hollowing is corrected.

The brow position can improve. As volume is restored to the temple, it provides structural support to the tail of the brow, which can create a subtle but noticeable lift to the outer brow. This opens up the eye area and can make the eyes appear larger, brighter, and more lifted. It's not a brow lift in the surgical sense, but many patients notice a visible improvement in their brow position after temple filler.

The overall facial harmony improves. The temples connect the forehead to the cheeks, and when they're hollow, that transition looks abrupt and angular. Filling the temples smooths out that transition and creates a more cohesive, flowing facial contour.

Perhaps most importantly, the result looks completely natural. Nobody will look at you and think you've had temple filler. They'll think you look rested, healthy, and well. It's one of the most "invisible" treatments in aesthetics, with one of the most visible overall impacts.

This is one of the most common questions we're asked, and the answer is yes, it can, though the degree varies from patient to patient.

The mechanism is straightforward. The tail of the eyebrow (the outer end) is partially supported by the volume in the temple region. As the temples hollow with age, this support diminishes, and the outer brow can gradually droop. This makes the eyes look heavier, smaller, and more hooded, and contributes to a tired or aged appearance.

When filler is placed in the temple, it restores the support beneath the brow tail. This can create a subtle but genuine lift to the outer brow, which in turn opens up the eye area and creates a more alert, youthful appearance.

The lift is not dramatic, and temple filler alone won't replace a surgical brow lift for patients with significant brow ptosis. But for patients with mild brow descent or a heaviness around the outer eye area, the improvement can be surprisingly noticeable. Many patients comment that their eyes look "more open" or that they look less tired after temple filler, even though the treatment didn't go anywhere near the eyes themselves.

For patients who want a more pronounced brow lifting effect, temple filler can be combined with Botox (placed strategically to relax the muscles that pull the brow down) for an enhanced result.

This depends on the degree of volume loss and the result you're looking for.

For mild temple hollowing where there's a slight concavity that you'd like to smooth out, around 1ml per side (2ml total) is often sufficient. For moderate hollowing where the temples are visibly concave and affecting the overall shape and proportions of the face, 1.5 to 2ml per side (3 to 4ml total) may be needed. For more significant volume loss, particularly in older patients or those who have experienced substantial weight loss, 2ml or more per side may be appropriate.

Dr Karwal will assess the degree of hollowing during your consultation and recommend the volume that will achieve the most natural, balanced result. It's always possible to take a conservative approach in the first session and add more at a follow up appointment if you'd like additional volume. Building gradually is often the safest and most natural looking approach, particularly for patients who are new to filler.

Yes, you'll see an immediate improvement. The hollow, concave appearance of the temples will be visibly smoother and fuller as soon as the filler is placed.

However, the result you see on the day is not quite the final outcome. There will be some mild swelling over the first 24 to 48 hours, which can make the area appear slightly fuller than the intended result. The filler also needs time to settle into the tissue and integrate with the surrounding structures.

Your true, settled result will be visible at around the two week mark. This is when Dr Karwal schedules a follow up to assess the outcome and determine whether any adjustments are needed. Most patients find the settled result is exactly what they were hoping for, with the temples looking naturally full and smooth without any visible sign of treatment.

Temple filler typically lasts between 12 and 24 months, and in many patients it lasts even longer.

The temples are a relatively low movement area. Unlike the lips or the area around the mouth, the temple tissue doesn't undergo constant movement from expressions, eating, or talking. This means the filler is subject to less mechanical stress, which helps it maintain its position and volume for longer.

The depth of placement also contributes to longevity. Filler placed deep in the temple, close to the periosteum (the tissue covering the bone) or within the deeper tissue layers, tends to last longer than superficially placed filler because it's less exposed to the metabolic processes that break down hyaluronic acid at the skin's surface.

Some patients report their temple filler lasting well beyond 18 months, particularly with repeat treatments. Over time, the filler can stimulate some degree of collagen production in the surrounding tissue, which means the area may hold its volume slightly better even as the filler itself is metabolised.

The same factors that affect filler longevity elsewhere in the face apply to the temples.

Your individual metabolism is the biggest variable. People who metabolise hyaluronic acid quickly will find their filler doesn't last as long. High intensity exercise, while excellent for overall health, can accelerate filler breakdown due to increased metabolic activity and blood flow.

The product used matters. Dr Karwal selects the specific filler based on your anatomy and the degree of hollowing. Products with higher cross linking (which makes them more resistant to breakdown) tend to last longer, and the temples can accommodate these slightly more robust fillers well.

The volume placed plays a role. Very small amounts of filler may be metabolised faster than a more substantial volume, simply because there's less product to break down. This is another reason why treating the temples adequately in the first session, rather than significantly underfilling, tends to produce longer lasting results.

Lifestyle factors like smoking, excessive sun exposure, and chronic stress can all accelerate the breakdown of hyaluronic acid in the body.

Proper aftercare helps the filler settle well and reduces the risk of complications.

For the first 24 hours, avoid touching, pressing, or rubbing your temples. Don't wear tight fitting glasses, sunglasses, or headbands that could apply pressure to the treated area. Avoid intense exercise, alcohol, saunas, steam rooms, and extreme heat. Sleep on your back if possible to avoid compressing the temples against a pillow.

For the first 48 hours, be gentle when washing your face and avoid applying heavy skincare products directly over the temple area. Don't lie on your side if you can help it.

For the first two weeks, avoid facials, facial massages, and any skin treatments in the temple region. Protect the area from excessive sun exposure. Avoid wearing hats or headgear that sits tightly across the temples.

You may experience some mild swelling, tenderness, and occasionally minor bruising in the first few days. These are completely normal and will resolve on their own. Cold compresses applied gently can help with any swelling. If you notice anything unusual such as increasing pain, significant asymmetry, skin discolouration, or visual disturbances, contact the clinic immediately.

You'll find us at 15 Dover Street, London W1S 4LP, in the heart of Mayfair, Central London. We're ideally situated for clients travelling from across London and beyond, with excellent transport links nearby. Book your consultation today.

Because temple hollowing develops gradually, many people don't recognise it in themselves. Here are the signs that suggest your temples may have lost volume.

You can see a visible indentation or shadow on either side of your forehead, between the outer edge of the eyebrow and the hairline. When you look at old photographs of yourself, your upper face looks narrower or more hollow than it used to. Your face has started to look more "bottom heavy," as though the widest part has shifted from the cheekbones downward. Your eyebrows appear to have dropped or flattened, particularly at the outer edges (the tail of the brow). You feel like you look gaunt or tired even when you're well rested. The overall shape of your face seems to have changed from oval or heart shaped to more rectangular or pear shaped.

If you press gently on your temple area and feel the bone beneath thin skin rather than a cushion of soft tissue, that's a clear indicator that volume has been lost.

Temple hollowing affects virtually everyone to some degree as they age, but certain groups are more likely to experience it earlier or more noticeably.

People with naturally lean faces and low body fat tend to show temple hollowing sooner because they have less facial fat to begin with. Those who have experienced significant weight loss often find the temples hollow dramatically, sometimes before other areas of the face show noticeable change. People with a genetic predisposition, particularly if hollow temples are visible in their parents or older siblings, are more likely to develop them earlier.

Athletes and frequent exercisers, especially endurance athletes, often show facial volume loss including the temples earlier than average. This is a common concern we see in patients who are physically fit but feel their face doesn't reflect their health or energy level.

Age is the most universal factor. Most people will notice some degree of temple hollowing by their forties, and it becomes increasingly apparent through the fifties and sixties. However, some patients in their early thirties already show visible hollowing, particularly if other contributing factors are present.

Most patients find temple filler very comfortable. The combination of the topical numbing cream and the lidocaine within the filler means the area is well numbed throughout the procedure. The treatment is also performed using a blunt cannula rather than a sharp needle, which makes a real difference to comfort. A cannula glides through the tissue rather than piercing it, resulting in less discomfort during the procedure and typically less bruising afterwards.

You'll likely feel some pressure as the filler is being placed, and possibly a mild stretching or pushing sensation as the volume is built up. Some patients describe a slight aching during and immediately after the injection, but this is typically mild and short lived.

The temple area is generally less sensitive than areas like the lips or nose, so most patients are pleasantly surprised by how manageable the procedure is. If you're particularly concerned about discomfort, let Dr Karwal know during your consultation and additional numbing can be arranged.