There is a tell-tale sign of ageing that most people cannot quite put their finger on. Patients sit across from me and say they look exhausted even when they are not, or that something has shifted but they cannot identify what. They have noticed fine lines, perhaps, or a little drooping around the jowls. But often, when I look at their face as a whole, the culprit is something far less obvious: their temples.
Temple hollowing is, in my view, one of the most underappreciated contributors to facial ageing. And treating it is one of the most rewarding things I do in clinic.
What Actually Happens to the Temples as We Age
To understand why temples matter so much, you need to think about the face not as a collection of individual features, but as a three-dimensional structure supported by bone, fat, muscle, and skin, all working in concert.
From our mid-thirties onwards, we lose bone density in the skull, including the temporal bone. The fat pads in the temporal region, and there are several distinct compartments of them, begin to shrink and descend. The temporalis muscle, which runs through this area, also loses volume over time. The result is a gradual caving inward of the area that sits between the outer edge of the eyebrow and the hairline.
What this does to the face is significant. When the temples hollow, the skin and soft tissue above the brow loses its support. The tail of the brow drops. The upper eyelid can start to look heavy or hooded. Cheekbones can appear less prominent, because the scaffolding above them has subtly collapsed. The face acquires a slightly skeletal quality, particularly visible in profile, that reads unmistakably as age and fatigue.
It is worth noting that temple volume loss does not discriminate. I see it in patients in their late thirties, and I see it quite dramatically in patients who have lost weight rapidly, who exercise intensely, or who have very lean body compositions generally. In those cases, the hollowing can appear even before other signs of facial ageing become prominent.
Why This Area Is So Often Overlooked
Most people seeking cosmetic treatments focus on the middle and lower face: the nasolabial folds, the lips, the jowls. And I understand why; these are the features that tend to attract the most attention and cause the most distress. But treating the lower face in isolation, without addressing volume loss higher up, can produce results that look slightly off without anyone being able to say precisely why.
Think of it like renovating a house from the ground floor up while the roof is sagging. You can polish the floors and repaint the walls, but structurally, something still feels wrong.
When I treat the temples before or alongside other areas, patients consistently notice that the whole face appears lifted, not just the temples themselves. The brow sits higher. The upper eyelid appears more open. Cheekbones look more defined. It is one of those treatments where the impact is quietly but profoundly transformative, and where patients are often surprised by how much difference a single, well-placed intervention can make.
This is also why I always assess the upper face carefully during consultations, even when a patient comes in asking about something else entirely. Temple hollowing is frequently the underlying cause of concerns that patients attribute to other areas: hooded eyes, a heavy brow, general facial fatigue. Addressing it changes the whole picture.
The Treatment: What It Involves
Temple augmentation using dermal filler is a well-established, safe, and effective procedure when performed by an experienced and medically trained practitioner. I use hyaluronic acid fillers, a substance that occurs naturally in the body, to restore volume to the temporal region.
The key to good temple treatment is precision and restraint. This is not an area to over-fill. The goal is to restore a gentle convexity, a subtle outward curve, that echoes what was there in youth. Done well, it should be completely undetectable. The aim is never for someone to look as though they have had a procedure; it is for them to look refreshed, healthy, and like themselves.
The injections are placed carefully, with a thorough understanding of the anatomy of the region. The temple contains important blood vessels, and I take great care to work safely around these at all times. In my clinic, I use needles or cannulas depending on the specific area being addressed and the individual patient’s anatomy. Every patient is unique, and the approach is always tailored to every individual.
Treatment typically takes around 20 to 30 minutes and involves minimal downtime. Most patients return to their normal activities the same day, but I advise avoiding strenuous exercise and significant heat exposure for the first 24 hours. There may be mild swelling or occasional bruising in the days immediately following treatment, but this settles quickly.
Results are visible immediately, though the filler continues to integrate and settle over the following two weeks, at which point I review every patient. The results typically last between 12 and 18 months, though this varies depending on the individual’s metabolism, lifestyle, and the specific product used.
The Wider Impact on the Face
What I find most compelling about temple treatment, and what I think justifies its place at the heart of any upper face rejuvenation plan, is the cascade of improvements it produces elsewhere. Restoring volume to the temples creates a lifting effect on the tail of the brow, which in turn opens up the upper eyelid and reduces the appearance of heaviness or hooding. It improves the overall contour of the face when viewed from the side, restoring the smooth, gently curved silhouette that characterises a youthful profile.
For patients who are considering blepharoplasty, surgical eyelid correction, for what appears to be excess upper eyelid skin, I always recommend assessing the temples first. In a meaningful number of cases, restoring temporal volume reduces or eliminates the apparent hooding without the need for surgery at all. That is not to say surgery is never the right answer, but it should not be the first answer when non-surgical options remain unexplored.
Is Temple Treatment Right for You?
If your face looks tired despite adequate sleep, if your brows appear to have dropped, if your upper eyelids feel heavier than they once did, or if you simply sense that something has changed without being able to identify exactly what, it is worth having your temples properly assessed.
The best outcomes always come from a thorough, unhurried consultation in which the face is evaluated as a whole, with treatment planned accordingly. At Health and Aesthetics, that is precisely the approach I take with every patient.
