previous page: 55/93 next

Coronal approach

Incision of the superficial temporal fascia for exposure of the zygomatic arch

Alternatively, the elevation of the superficial layer of the temporalis fascia in the dissection to the zygomatic arch can be done bluntly using scissors.
A common complication of the temporal fat pad approach is a hollowing of the temporal fossa, which may represent a significant cosmetic deformity. Current understanding is that postoperative temporal hollowing is a consequence of a fat atrophy caused by devascularization, denervation, or displacement of the fat pad. In order not to injure the connective tissue septations suspending the fat pad and to prevent inferior sagging, the dissection should be kept on the lateral surface.
Transsection of the branches of the zygomaticotemporal nerve travelling perpendicular through the fat pad, however, is unavoidable.