Modified temple incision for facial rhytidectomy

A modified temple incision is discussed. The incision has been used on 286 patients. The incision starts cephalad in the temple hair, continues caudally parallel to the ear axis along the caudal border of the sideburn, turns cephalad close to the helix, and then continues along the anterior border of the ear. The advantages of the incision are numerous. First, it virtually eliminates any possibility for injury to the temporal branches of the facial nerve and preserves the temporal vessels. Second, the temple and sideburn skin flap is not elevated so the chance of hair loss is minimal. Third, the incision significantly increases the distribution length of the excised area; this minimizes any possibility of "dog ear" formation. Midface and upperface rhytidectomies are more effective because the skin is pulled a shorter distance. The drawbacks of the incision are the possibility of a visible scar in the most caudal portion of the sideburns and added surgical time because of the need for meticulous incision repair.