Temporal Lift

A temporal lift (also called a lateral brow lift) treats the area beside the eyes: the brow tail, the outer corner of the eye, the outer upper eyelid and the temple. Through an incision hidden inside the temporal hairline, the sagging temporoparietal fascia and the soft tissue above it are lifted upward and outward and fixed to the deep temporal fascia, and excess skin is trimmed at the incision. A full facelift treats the mid and lower face, jawline and neck through incisions in front of and behind the ear; central forehead lines and the area between the brows belong to an endoscopic forehead lift. A temporal lift does not treat those areas.

Try this in a mirror: sit upright, relax your forehead, and gently push the skin of your temple up and outward with one finger. If most of the fold disappears, the problem is mainly the brow tail and temple. If a lot of skin remains, the upper eyelid may also have excess skin and needs to be assessed too. Removing upper-eyelid skin while the brow tail stays low can pull the brow even closer to the eye. If you also have under-eye bags, lower-eyelid surgery can be done in the same session as the temporal lift.

The incision sits inside the temporal hairline, about 5 to 7 cm on each side. It is cut at an angle so hair follicles can grow through the scar, which is covered by hair; there is no incision on the face. Hairline height, forehead length and hair density all change the design, so if your hairline is already high or your hair is thin, the incision position is discussed before surgery. The scar fades over time but does not vanish; in a small number of people it widens or hair does not grow back along it.

The surgery is done under local anesthesia plus gentle pain-relief anesthesia. Before anesthesia, the doctor marks the direction and amount of lift for the brow tail and outer eye while you sit upright, and marks the superficial temporal artery with ultrasound. Afterwards the scalp incision feels tight and the temple and eye area swell and bruise; pain medication is prescribed for your situation.

A compression dressing is applied to the temple at the end of surgery and is usually removed at a visit the next day; the hairline stitches are removed at a visit about 14 days after surgery. Early on you can use cold compresses as instructed, sleep with your head raised, and avoid sleeping face-down or on the operated side. Keep the incision clean and dry and wash your hair as instructed; until the incision is stable, avoid hair colouring or perms, rubbing the temple or outer eye, strenuous exercise, lifting heavy objects with your head down, saunas and hot environments. Right after surgery the brow tail may look high and the eye shape tight; the stable result appears once the swelling settles and the tissue relaxes a little.

It depends on how much laxity there is and at which layer. Radiofrequency and focused ultrasound tighten tissue with heat but change position only a little. A thread lift suspends tissue toward an anchor point and suits mild to moderate sagging where the tissue is still near its original position, but threads can only carry so much. When the brow-tail laxity is beyond what threads and energy devices can handle, a temporal lift fits: it refixes the fascia directly and can remove excess skin. If the laxity is still mild, there is no need to go straight to surgery just to "do it all at once."

First work out how much is hollowing and how much is laxity. If the temple is clearly hollow and the brow tail only slightly low, the main problem is volume loss; lifting alone leaves the hollow in place. If the brow tail clearly droops and the temple is only slightly hollow, the main problem is sagging; adding volume alone will not hold the brow tail up. Most people are somewhere in between, and whether to graft and lift in one session, and in what order, is decided at consultation. If you have had filler in the temples and can feel lumps, or have had threads placed in the temple, we first check the material and its layer with ultrasound and, if needed, deal with the old material first.

Ageing continues, so no lift stays unchanged forever. The largest long-term follow-up is Verpaele et al. 2015, 923 cases (PMID:25502857): among patients followed for 5 years or more, lateral hooding and brow position were markedly improved in over 90%, and relapse after 5 years was under 10%. This is one team's experience; real results depend on skin quality, degree of laxity and lifestyle, and an uneven height between sides or a later relapse may need adjustment.

Temporal lifts are performed at our Taipei Xinyi (Main) and Kaohsiung Wenkang clinics, assessed and operated on by Dr. Ta-Ju Liu. Bringing a front-facing photo with a relaxed expression and brows not raised makes the consultation more efficient; whether it suits you is decided in person, with the brow tail and outer eye assessed while you sit upright.