What is a major limiting factor for the use of a temporalis flap?

The major limiting factor for the use of a temporalis flap is temporal hollowing. This occurs because the temporalis muscle is an important structure for chewing and facial aesthetics; when it is harvested to create a flap, there can be a noticeable loss of volume in the temple region, leading to an aesthetic deformity. Patients often seek reconstruction not just for functional reasons but also for cosmetic concerns. The loss of the temporalis muscle can result in a sunken appearance, which can affect a patient's self-esteem and overall satisfaction with their surgical outcome.

While other factors, such as infection risk, skin necrosis, and bone resorption, can arise in flap surgeries, they do not specifically limit the ability to use the temporalis flap itself in the way that temporal hollowing does. This aesthetic concern makes temporal hollowing a significant downside to this type of flap, particularly in younger patients or those particularly conscious about the appearance of their face.