BACKGROUND: Autologous fat grafting (AFG) has been widely used in temporal hollowing augmentation, while the efficacy and safety were unstable. To solve these problems, we suggested large-volume lipofilling with doppler-ultrasound (DUS) guided of the temporal region by the anatomical study. MATERIALS AND METHODS: To clarify the safe and stable levels of AFG of the temporal fat compartments, 5 cadaveric heads (10 sides) were dissected after dye was injected into targeted fat pads with DUS guided. We retrospectively analyzed 100 patients with temporal fat transplantation, including the groups of conventional autologous fat grafting (c-AFG, n=50) and DUS guided large-volume autologous fat grafting (lv-AFG, n=50). RESULTS: The anatomical study revealed the approach of five injection planes and two fat compartments in the temporal region: superficial and deep temporal fat pads. In clinical review of the two AFG groups, all genders were female and there were no statistical differences in age, body mass index (BMI), tobacco or steroids use and previous filling history, etc. Between the c-AFG group and the lv-AFG group, average volume of temporal lipofilling per side was (10.55±2.25 vs 22.32±5.19, p<0.001) ml/side, Likert scale score of surgeons was (2.86±0.97 vs 4.24±0.66, p<0.001), rate of satisfaction was (74% vs 92%, p=0.017 <0.05), and the three types of statistics had statistically significant differences. CONCLUSION: The anatomical approach of the main temporal fat compartment is feasible, and DUS guided large-volume AFG is an effective and safe way to improve temporal hollowing augmentation or aging. EVIDENCE LEVEL: III.