Identification and Complications of Cosmetic Fillers

Abstract

Cosmetic fillers are frequently used these days for enhancing beauty and to treat wrinkles or sagging skin. However, information on the history of injections may be difficult to obtain, and there is a growing number of reports on complications with these agents. In contrast to other imaging techniques, sonography has been successfully used for detecting and identifying common types of cosmetic fillers and has become the first‐line imaging modality to deal with these exogenous components.

Ultrasound Morphology of Polycaprolactone Filler

“…In contrast to clinical reports that mention that the deposits of polycaprolactone are located in the dermis, we found this filler primarily in the hypodermis in all patients. This coincides with previous reports that demonstrate the sonographic presence of common types of cosmetic fillers in the hypodermis . Hence, the latter finding is not surprising, and in addition to the skills and training of the operator, it may be the result of normal anatomical conditions such as the thin dermis of the face and the length of the needle that comes with the kits of the fillers, because usually the needle is longer than the thickness of the facial dermis .…”

“…The hyperechoic spots with mini‐comet‐tail artifact that we described in polycaprolactone have been also reported in polymethylmethacrylate; however, the echogenicity of the matrix of polycaprolactone is hypoechoic, and in polymethylmethacrylate, the matrix of the deposits is hyperechoic (Figure ). Probably, the presence of these bright hyperechoic spots with mini‐comet‐tail artifact can be related to the microspheres present in both types of cosmetic fillers.…”

“…The ultrasound morphology of polycaprolactone was different from the sonographic appearance of other common cosmetic fillers, such as hyaluronic acid, which is anechoic or hypoechoic and does not contain bright hyperechoic spots (Figure ) …”

“…Sonography can detect and identify common cosmetic fillers as well as show the skin layers and the anatomical changes in frequent dermatologic conditions with good definition …”

“…Regarding cosmetic fillers, it has been described that ultrasound can confirm their presence, discriminate the most common types, and locate, measure, and monitor over time the filler deposits . Therefore, sonography has been reported as the first‐line imaging modality for assessing complications arising from the use of cosmetic fillers …”