Temporal hollowing, or temporal atrophy, is a common facial change. This concavity occurs in the area between the outside edge of the eyebrows and the hairline, anatomically termed the temporal fossa. While often mistaken for a serious sign of aging, this sunken appearance is primarily a consequence of natural volume loss in the soft tissues of the face. For most people, the condition is not a medical concern but an aesthetic one, resulting from predictable anatomical changes that occur over time.
Understanding the Anatomy of the Temporal Area
The temporal fossa is the visible space, or “dent,” which is a natural depression in the side of the skull. This bony space is bordered by the zygomatic arch (cheekbone) at the bottom and the temporal lines of the skull at the top. Underneath the skin, the fossa is filled by the temporalis muscle, used for chewing, and several distinct fat compartments. These structures, particularly the deep temporal fat pad, normally provide a smooth, convex contour that blends the forehead with the cheekbone. A youthful appearance relies on the fullness of these soft tissue layers to mask the underlying bony contours.
Primary Causes of Volume Depression
The visibility of the temporal dent is driven by a combination of factors, with age-related atrophy being the most significant contributor. The temple region experiences the greatest proportional soft tissue loss of the entire face as we age.
Age-Related Atrophy
Atrophy of the deep temporal fat pad, which provides structural support, is a major cause. This fat loss causes the overlying skin and tissue to sink inward, making the depression more noticeable. Beyond fat loss, the natural breakdown of structural proteins exacerbates the hollowing. The production of collagen and elastin slows down over the decades, leading to thinner, less resilient skin that drapes more closely over the underlying temporalis muscle and bone.
Bone Resorption
Changes to the underlying skeletal framework were once thought to be a major factor. However, studies comparing young and older adult skulls have shown that the bony dimensions of the temporal fossa remain relatively stable with age. This finding suggests that the visible hollowing is overwhelmingly due to soft tissue loss, not a widening of the bone structure.
Lifestyle and Weight Fluctuations
Significant or rapid weight loss can accelerate the appearance of temporal hollowing. Facial fat, including the fat pads in the temple area, is often one of the first stores of adipose tissue the body metabolizes. When volume is lost quickly, the skin does not adjust, resulting in a gaunt or sunken look. Individuals who maintain a very low body fat percentage, such as endurance athletes, may also notice pronounced hollowing at a younger age. Genetics can also predispose some people to naturally have less volume in this area.
Addressing the Appearance of Temple Dents
Solutions for temporal hollowing focus on restoring the lost volume. These interventions range from temporary procedures to more permanent surgical options, and they are typically performed by dermatologists or plastic surgeons.
Non-Invasive Cosmetic Treatments
Dermal fillers are the gold standard for non-surgical correction, temporarily replacing diminished fat and tissue. Injectable gels, most commonly based on hyaluronic acid, are placed deep into the temporal fossa to immediately restore a smooth contour and soften the upper face. Biostimulatory fillers, such as poly-L-lactic acid, offer an alternative by encouraging the body to produce its own collagen over several months. For a more lasting solution, fat grafting involves harvesting fat from another area of the body and transferring it to the temples, offering permanent volume restoration using the patient’s own tissue.
Lifestyle Management
While cosmetic procedures offer the quickest correction, lifestyle management can support the health of the temporal volume. Protecting the skin from the sun is important, as ultraviolet radiation accelerates collagen and elastin breakdown. Consistent use of broad-spectrum sunscreen helps preserve the skin’s structural integrity. Proper nutrition and hydration also contribute to overall skin quality, as a diet rich in antioxidants and healthy fats supports elasticity and cell repair.