Reticulated livedoid skin patterns after soft-tissue filler-related vascular adverse events.

Background: For the treatment of vascular adverse events caused by filler injections, duplex ultrasound imaging may be used. The findings of duplex ultrasound examination and the clinical features of reticulated livedoid skin patterns were compared with the hemifaces anatomy.

Objective: The objective of this study was to link the reticulated livedoid skin patterns to the corresponding duplex ultrasound findings and the facial perforasomes.

Investigating the Anatomic Location of Soft Tissue Fillers in Noninflammatory Nodule Formation: An Ultrasound-Imaging-Based Analysis.

Introduction: Noninflammatory nodules may be persistent to dissolve. To evaluate the possible reasons, a case series of ultrasound images and medical data of patients who were prospectively referred with noninflammatory nodules were evaluated.

Materials And Methods: A total of 27 patients with nodules but without signs of inflammation were included.

Bacterial Contamination Is Involved in the Etiology of Soft-Tissue Filler, Late-Onset, Inflammatory Adverse Events.

Background: The treatment algorithm in late-onset inflammatory adverse events with soft-tissue fillers depends primarily on the assumed causative factor: immunologic or bacterial.

Methods: The authors included 29 patients, 13 of whom experienced late-onset inflammatory adverse events to fillers (inflammatory group) and 16 who did not (reference group). Biopsies were acquired from both groups with an 18-G needle.

Precision of Soft-Tissue Filler Injections: An Ultrasound-Based Verification Study.

Background: Uncontrolled product spread is an important issue to consider in facial filler injections. Lack of precision can result in reduced effectiveness and surface projection, as well as irregularities and product visibility.

Objectives: The authors sought to assess the precision of soft-tissue filler injections in the face by employing a cannula.

Ultrasound-Guided Targeted vs Regional Flooding: A Comparative Study for Improving the Clinical Outcome in Soft Tissue Filler Vascular Adverse Event Management.

Background: Adverse vascular event management following hyaluronic acid-based aesthetic injections relies on the administration of hyaluronidase which is capable of enzymatically degrading the injected product and improving clinical symptoms. Two protocols are currently available to manage such complications: "ultrasound-guided targeted" and "flooding".

Objectives: The aim of this study was to compare the 2 protocols in terms of the volume of hyaluronidase utilized, and the onset and degree of clinical improvement.

A Guide to Doppler Ultrasound Analysis of the Face in Cosmetic Medicine. Part 2: Vascular Mapping.

Duplex mode ultrasound imaging can detect the course of the main vascular structures in the face, which are known to be subject to variation. Once duplex mapping has been performed, measures can be taken to prevent injection into an artery, thereby avoiding skin necrosis or, worse, vision loss. For this reason, in particular, we predict that in the coming years sonography will become standard equipment in the offices of cosmetic doctors.

A Guide to Doppler Ultrasound Analysis of the Face in Cosmetic Medicine. Part 1: Standard Positions.

Interest in Doppler ultrasound (DUS) analysis of the face has grown in cosmetic medicine, in particular for injectable fillers. When dealing with complications, DUS has the advantage of easily visualizing the filler and identifying the problem in relation to the patient's anatomy. When working with hyaluronic acid filler, ultrasound-guided injections with hyaluronidase can precisely target the problem.

Increased risk of late-onset, immune-mediated, adverse reactions related to dermal fillers in patients bearing HLA-B*08 and DRB1*03 haplotypes.

Even though manufacturers claim that the dermal fillers are nontoxic and nonimmunogenic, adverse events may occur. Clinically and histologically, most of the late onset adverse events present as an inflammatory response. To assess whether HLA polymorphisms are associated with late-onset inflammatory adverse events related to dermal fillers.

Ultrasound to Improve the Safety and Efficacy of Lipofilling of the Temples.

Background: Autologous fat is known for a reliable and natural safety profile, but complications do occur-even serious vascular adverse events.

Objectives: The authors sought to examine doppler-ultrasound (DUS) imaging for the harvesting and subsequent facial implantation of autologous fat tissue.

Methods: All patients underwent lipofilling treatment of the temporal fosse of the face.

Nomenclature proposal for the sonographic description and reporting of soft tissue fillers.

Background: There is a steady increase in publications about the use of ultrasound and filler treatments, written by physicians from different specialties. The terminology used to describe the ultrasound images of fillers is not uniform, making the different articles difficult to compare. Standardization of the descriptions based on their basic sonographic parameters is recommendable.

Early ultrasound for diagnosis and treatment of vascular adverse events with hyaluronic acid fillers.

Background: Hyaluronic acid fillers are known for a reliable safety profile, but complications do occur, even serious vascular adverse events.

Objective: To improve the treatment outcome after a vascular adverse event with use of hyaluronic acid filler treatments.

Methods: Duplex ultrasonography is used to detect the hyaluronic acid filler causing the intra-arterial obstruction.

Ultrasound to improve the safety of hyaluronic acid filler treatments.

Background: Hyaluronic acid fillers are known for a reliable safety profile, but complications do occur, even serious vascular adverse events.

Objective: To improve the safety of hyaluronic acid filler treatments.

Methods: Ultrasound is used to image hyaluronic acid fillers.

Intralesional Laser Treatment for Dermal Filler Complications.

Background: For complications caused by filler treatments, in general, two treatment regimens are advised: systemic drugs and surgical removal of the material. Another possible treatment option would be removal of the material by intralesional laser treatment.

Methods: Two hundred forty-two patients with complications caused by fillers were treated with intralesional laser treatment.

Polyalkylimide: A Nonstable Filler Over Time.

Background: Polyalkylimide hydrogel is supposed to be a permanent, biocompatible implant. However, years after subcutaneous implantation clinical complications are seen.

Objective: To increase the understanding of the changes that occur over time in this subdermal implanted filler.

Use of ultrasound to provide overall information on facial fillers and surrounding tissue.

Background: Information on fillers and their behavior over time in the different layers of tissue is limited. Ultrasound may be used to visualize these fillers and their surrounding tissue to broaden knowledge.

Objective: To evaluate the use of ultrasound as a diagnostic and research tool to obtain information on facial fillers and their behavior in human tissue.

Complications after treatment with polyalkylimide.

Background: Polyalkylimide is a nonresorbable, biocompatible polymeric filler that has been used for several years to treat soft tissue deficits. The literature has shown a minor complication rate. We noticed that complications typically appear several years after injection.