The use of high-frequency ultrasonography for the diagnosis of palpable nodules after the administration of dermal fillers

Abstract

Introduction: Esthetic medicine is a buoyant field of medicine. As the number of performed procedures – mainly injections of botulin toxin and dermal fillers – is increasing, the number of complications is rising as well. The most popular dermal filler is hyaluronic acid. Injection of hyaluronic acid dermal fillers is considered a minimally invasive procedure, but complications in the form of skin nodules and lumps are being encountered more and frequently. Esthetic medicine does not currently offer its own diagnostic methods that would allow one to diagnose complications. In these circumstances, the implementation of objective diagnostic methods from other fields of medicine becomes significant. High-frequency ultrasound is one of such methods. Aim of the study: The aim of this study was to implement high-frequency ultrasound for the diagnosis of palpable nodules after the administration of dermal fillers. Material and method: The study group included 15 women who developed palpable nodules in the region of hyaluronic acid injection. The study includes both early and late complications. An EPIQ 5 (Philips, Bothell, USA) ultrasound machine and a L5–18 transducer were used to examine the nodules. Ultrasound images were evaluated qualitatively by 2 independent investigators. Results: Ultrasound enabled the diagnosis of hyaluronic acid deposition in 9 women, granulomas in 3 women, fibrosis in 2 women and a deposition with inflammation in 1 case. Each of the diagnosed structures presented a typical ultrasound appearance. Conclusions: High-frequency ultrasound is a useful diagnostic method that has a chance to become a widespread tool to diagnose and treat complications. Because of a low number of study reports in this area, continued research is warranted.

Increasing precision during neuromodulator injections for frontal rhytids—Using ultrasound imaging to identify the line of convergence

“…This study was designed as a pilot study to explore the feasibility and practicality of implementing pre‐injection ultrasound scanning into aesthetic neuromodulator treatments. Pre‐treatment ultrasound is starting to become or has already become the standard of care in several countries for soft tissue filler injections 11–19 . When used in conjunction with soft tissue filler administration, the patient receives pre‐treatment facial scanning to identify the 2D and 3D location of facial arteries and to evaluate previous aesthetic filler treatments 12,15,17,20–23 .…”

“…Pre-treatment ultrasound is starting to become or has already become the standard of care in several countries for soft tissue filler injections. [11][12][13][14][15][16][17][18][19] When used in conjunction with soft tissue filler administration, the patient receives pre-treatment facial scanning to identify the 2D and 3D location of facial arteries and to evaluate previous aesthetic filler treatments. 12,15,17,[20][21][22][23] This information is crucial for the injector to determine the plane of product placement in relation to the respective facial vessel and to obtain knowledge about the type and location of a possible previous soft tissue filler treatment, ultimately aiming to increase patient safety and to improve aesthetic outcomes.…”

“…[11][12][13][14][15][16][17][18][19] When used in conjunction with soft tissue filler administration, the patient receives pre-treatment facial scanning to identify the 2D and 3D location of facial arteries and to evaluate previous aesthetic filler treatments. 12,15,17,[20][21][22][23] This information is crucial for the injector to determine the plane of product placement in relation to the respective facial vessel and to obtain knowledge about the type and location of a possible previous soft tissue filler treatment, ultimately aiming to increase patient safety and to improve aesthetic outcomes. However, pre-treatment scanning is not routinely practiced for neuromodulator treatments.…”

Personalization of Minimally-Invasive Aesthetic Procedures with the Use of Ultrasound Compared to Alternative Imaging Modalities

“…Serial US assessments enable clinicians to track the resolution of complications over time, providing insights into the effectiveness of therapeutic interventions. This dynamic monitoring approach allows further adjustments in management plans, based on the evolving characteristics of nodules or granulomas [49]. Furthermore, US aids in identifying potential recurrences or the development of new complications, enabling early intervention and minimizing patient discomfort.…”