Commentary on: Three-Dimensional Computed Tomography Scanning of Temporal Vessels to Assess the Safety of Filler Injections

Sunken temples, which can contribute to a person looking aged and/or fatigued, are generally treated by injecting filler—this contouring is now one of the most commonly performed aesthetic procedures. The importance of the anatomy of the temporal vessels cannot be overemphasized when performing aesthetic injection of fillers, especially with needles, to improve facial contours. One common technique is to deliver fillers by needle. The needle is placed perpendicular to the skin and advanced slowly until the tip is felt to contact the bone. Some experts prefer to start from the highest point of the temporal area and work down, typically performing multiple needle insertions to cover the deficient area.1 Because vascular accidents can occur during injection, the identification of complex temporal vasculatures is always a hot topic of discussion. Luo et al investigated the anatomy of the temporal vessels to provide more accurate 3-dimensional (3D) computed tomography (CT) images for temple filler injection.2 Traditional 2D information, mainly based on cadaveric dissection of autopsy specimens, provided insufficient understanding of the depth of temple vessel anatomy.3,4 This led to an increasing number of publications utilizing either ultrasound or 3D CT to define the locations of the facial vessels.5-7 Luo et al tried to utilize 3D CT scanning followed by image analysis with Mimics software in a coordination system to digitally clarify the exact positions of the temporal vessels in order to improve the safety of filler injections in the temporal region.2