Ultrasound to improve the safety of hyaluronic acid filler treatments

Schelke, Leonie; Decates, Tom; Velthuis, Peter

doi:10.1111/jocd.12726

Cited by 58 publications

(72 citation statements)

References 23 publications

(24 reference statements)

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“…It allows for localization of a filler deposit responsible for arterial compression. Then, it provides guidance for accurate needle introduction and injection of hyaluronidase to dissolve the deposit (15) . Doppler options allow for a simultaneous assessment of positive outcomes of the intervention used, i.e.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Doppler sonography in aesthetic medicine

et al. 2020

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Introduction: In recent years, ultrasonography has been used in an increasing number of fields, such as dermatology, aesthetic medicine and cosmetology. For skin imaging, research has shown the usefulness of both classic scanners equipped with linear transducers, and high-frequency scanners with mechanical transducers. An increasing number of reports indicating high usefulness of Doppler sonography have been published recently. The aim of this study was to assess the usefulness of high-frequency Doppler imaging in the diagnosis of vascular complications after aesthetic procedures using tissue fillers. Materials and methods: A total of 12 women aged 19–48 years (mean age 36.08 years) who had undergone hyaluronic acid treatment were included in the study group. Ultrasound scans were performed using standard ultrasound scanners, i.e. Philips Epiq 5 with a linear transducer and Samsung RS85 with linear transducers and Doppler Microflow Imaging option. Ultrasound scans were performed to assess the presence of blood flow using Color Power Doppler (CPA). Pulsed- Wave Doppler was used only for arteries. If no blood flow was recorded with Color Power Doppler, Microflow Imaging was used. Results: Doppler ultrasound showed normal blood flow despite reported symptoms in 3 cases. Vascular stenosis was found in 2 patients. In the other 7 patients, Doppler ultrasound showed no blood flow at the sites where complications developed. Conclusions: Skin ultrasound with Doppler options is a useful tool in the diagnosis of aesthetic medicine complications.

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Section: Discussionmentioning

confidence: 99%

Usefulness of Doppler sonography in aesthetic medicine

et al. 2020

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“…There are some studies in which ultrasound has been applied to evaluate dermal fillers or in which dermal fillers have been administered under ultrasound guidance. Some studies have also evaluated complications (9)(10)(11)(12)(13) . It must be emphasized that all these studies draw attention to the usefulness of highfrequency ultrasound for the evaluation of dermal fillers.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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“…A 32-year-old woman presented for a cosmetic consultation to address unilateral swelling of the left cheek ( Figure 1A Ultrasound is very helpful in cases of adverse events after being injected with hyaluronic acid gel fillers. 4 With this a large hypo-echogenic area, interpreted as an abscess, was visible and there existed a hypo-echogenic tract toward the second bicuspid on the left side of the maxilla (tooth nr 25), possibly a fistula ( Figure 1B). A closer look inside the mouth showed a decayed second bicuspid in the left side of the upper jaw and she was therefore referred to the dentist ( Figure 1C).…”

Section: Case Reportmentioning

confidence: 99%

Unilateral facial edema after filler injection of the lower eyelid

Decates

Spanjer

Saini³

et al. 2020

Dermatologic Therapy

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The use of hyaluronic acid (HA) gel fillers for rejuvenation of the face has been increasing in popularity over the years. This nonsurgical, temporary technique is commonly used in the periocular region to restore volume. The aim of this study was creating awareness in the potential causes of edema after hyaluronic acid gel filler injections under the eyes. A 32‐year‐old woman presented for a cosmetic consultation to address unilateral swelling of the left check. She states she had an HA filler injected in the tear trough on both sides. Extensive evaluation and ultrasound were performed by physicians of different specialties. Intra‐oral and radiological examination revealed a tooth‐related cause known as apical periodontitis. Removal of this tooth resulted in complete resolution of the patient's presenting symptoms. Familiarity with all the potential causes of adverse events after injections with hyaluronic acid gel fillers accelerates the treatment and healing of the patient with complications. Reporting this case should raise awareness about possible teeth‐related complications.

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Ultrasound to improve the safety of hyaluronic acid filler treatments

Abstract: Ultrasound examination can be an important tool to improve the safety of hyaluronic acid filler treatments.

Cited by 58 publications

References 23 publications

Usefulness of Doppler sonography in aesthetic medicine

Usefulness of Doppler sonography in aesthetic medicine

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

Unilateral facial edema after filler injection of the lower eyelid

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