Middle temporal vein thrombophlebitis, multicompartment deep neck infection, and Lemierre syndrome following temporal lifting: a previously unreported complication chain

Abstract

Temporal lifting is widely performed as an aesthetic procedure with a generally favorable safety profile, yet rare and clinically significant complications may arise due to the anatomical continuity between the temporal region and deep cervical spaces. This report presents an uncommon case in which a healthy woman developed a rapidly progressive sequence of middle temporal vein thrombophlebitis, multicompartment deep neck infection, and Lemierre syndrome (an infectious thrombophlebitis of the internal jugular vein often leading to systemic septic embolization) shortly after temporal lifting. Her symptoms evolved from localized temporal discomfort to trismus, swallowing difficulty, and extensive cervical inflammatory spread, prompting suspicion for deep neck involvement. Magnetic resonance imaging provided critical diagnostic clarity by demonstrating venous thrombosis, diffuse soft tissue infiltration, and narrowing of the parapharyngeal airway. Early administration of broad spectrum antimicrobial therapy, therapeutic anticoagulation, and close respiratory monitoring resulted in full clinical recovery. This case emphasizes that even superficially performed facial rejuvenation procedures may trigger extensive infectious and vascular processes through established fascial pathways. To the best of current knowledge, this is the first reported occurrence of the combined presentation of temporal venous thrombophlebitis, widespread deep neck infection, and Lemierre syndrome following temporal lifting. These observations highlight the importance of early imaging and clinical vigilance in patients presenting with disproportionate postoperative symptoms.