BACKGROUND: Poly-l-lactic acid (PLLA-SCA) can be used to improve the aesthetics of the temporal fossae but is usually only deposited within the visible area of the temporal hollows. However, extending the treatment area posterior to the hairline may provide a greater lifting effect. OBJECTIVES: Assess the efficacy and safety of 2 techniques (traditional vs extended) of injecting PLLA-SCA for aesthetic improvement of the temporal fossae. MATERIALS AND METHODS: A prospective, randomized-controlled clinical trial was conducted. Twenty-four subjects were randomized in a 1-to-1 ratio to the traditional or extended injection technique. Subjects received 3 treatments (Baseline, Week 7, Week 14) and were evaluated for follow-up at Weeks 20, 26, and 38. Assessments included the Global Aesthetic Improvement Scale (GAIS), Temple Volume Deficit Scale (TVDS), lifting and volumizing effects, subject satisfaction, and adverse events. RESULTS: A greater facial lifting effect (p <
.001) and mean decrease in TVDS scores were observed with the extended injection technique. Regardless of injection technique, all subjects were at least improved on the GAIS at Week 38, and there was a low frequency of adverse events. CONCLUSION: Poly-l-lactic acid is a safe and effective treatment for improving the aesthetic appearance of the temporal fossae. Outcomes can be maximized using an extended injection technique.