Usefulness of Doppler sonography in aesthetic medicine

Abstract

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.

Description of a safe doppler ultrasound‐guided technique for hyaluronic acid filler in the face—A method to avoid adverse vascular events

“…We emphasize that the device used does not visualize all the vessels of the face, only those with a diameter of 0.1 mm or over 4 . Given that the 27 G cannula has a diameter of 0.4 mm, 5 the injector will be safe to perform the filling when using any cannula above 27 G. The safety when using needle must be studied in future studies.…”

Ultrasound‐assisted management of filler‐related complications: Report of a successful treatment of delayed‐onset nodules related to polycaprolactone‐based filler

“…Using USG with Doppler properties enables esthetic physicians to safely inject in appropriate tissue layers, minimizes vascular and other adverse events and facilitates diagnosis and treatment of complications. 3,10,11 In this report, we present a late PCL filler-related complication (nodule formation triggered by viral infection) which could not be easily treated without the use of USG. This case underscores the indispensable role of USG in esthetic treatments and management of filler complications.…”

Bridging a Century-Old Problem: The Pathophysiology and Molecular Mechanisms of HA Filler-Induced Vascular Occlusion (FIVO)—Implications for Therapeutic Interventions

“…The use of Doppler ultrasound (US) has recently grown in acceptance as a means of identifying aberrant/anomalous vascular structures prior to dermal filler injection and avoiding accidental vaso-cannulation [ 138 , 139 ]. Proponents of US advocate its routine use predominantly in high-risk areas—such as the ophthalmic artery-supplied territories of the forehead, glabella, and nasal dorsum —where it can be employed for both arterial mapping and ultrasound-guided filling [ 140 , 141 , 142 ]. US may also prove useful in cases of FIVO, helping to identify sites of vascular occlusion and assisting with the precise delivery of reversal agents [ 143 , 144 ].…”