Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Ultrasonography in the management of lip complications caused by hyaluronic acid

  • Received : 2024.01.26
  • Accepted : 2024.05.28
  • Published : 2024.09.30
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Abstract

Ultrasonography is highly accurate for evaluating soft tissues. Given that minimally invasive aesthetic procedures are on the rise, complications have become more prevalent. Thus, ultrasonography holds promise for assisting in the diagnosis and management of complications arising from these interventions. This report highlights the importance of ultrasonography in the treatment of complications caused by hyaluronic acid injection. A patient visited a dental office 24 hours after hyaluronic acid application, presenting pain and bruising in the middle and inferior thirds of the face on the right side. To evaluate blood vessels, the surgeon used Doppler-mode ultrasonography, which enabled the precise application of hyaluronidase to reestablish blood perfusion and preserve adjacent structures. Therefore, to avoid severe outcomes, such as necrosis or even amaurosis, the use of ultrasonography is suggested, improving the precision and safety of these procedures.

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References

  1. Pallagatti S, Sheikh S, Puri N, Mittal A, Singh B. To evaluate the efficacy of ultrasonography compared to clinical diagnosis, radiography and histopathological findings in the diagnosis of maxillofacial swellings. Eur J Radiol 2012; 81: 1821-7. https://doi.org/10.1016/j.ejrad.2011.04.065
  2. Wortsman X. Identification and complications of cosmetic fillers: sonography first. J Ultrasound Med 2015; 34: 1163-72. https://doi.org/10.7863/ultra.34.7.1163
  3. Jagus D, Skrzypek E, Migda B, Wozniak W, Mlosek RK. Usefulness of Doppler sonography in aesthetic medicine. J Ultrason 2020; 20: e268-72.
  4. Velthuis PJ, Jansen O, Schelke LW, Moon HJ, Kadouch J, Ascher B, et al. A guide to Doppler ultrasound analysis of the face in cosmetic medicine. Part 1: standard positions. Aesthet Surg J 2021; 41: NP1621-32.
  5. Velthuis PJ, Jansen O, Schelke LW, Moon HJ, Kadouch J, Ascher B, et al. A guide to doppler ultrasound analysis of the face in cosmetic medicine. Part 2: vascular mapping. Aesthet Surg J 2021; 41: NP1633-44.
  6. Wortsman X, Wortsman J, Orlandi C, Cardenas G, Sazunic I, Jemec GB. Ultrasound detection and identification of cosmetic fillers in the skin. J Eur Acad Dermatol Venereol 2012; 26: 292-301. https://doi.org/10.1111/j.1468-3083.2011.04047.x
  7. Munia MA, Munia CG, Parada MB, Ben-Hurferraz Parente J, Wolosker N. Doppler ultrasound in the management of vascular complications associated with hyaluronic acid dermal fillers. J Clin Aesthet Dermatol 2022; 15: 40-3.
  8. Ozturk CN, Li Y, Tung R, Parker L, Piliang MP, Zins JE. Complications following injection of soft-tissue fillers. Aesthet Surg J 2013; 33: 862-77. https://doi.org/10.1177/1090820X13493638
  9. Goodman GJ, Magnusson MR, Callan P, Roberts S, Hart S, McDonald CB, et al. A consensus on minimizing the risk of hyaluronic acid embolic visual loss and suggestions for immediate bedside management. Aesthet Surg J 2020; 40: 1009-21. https://doi.org/10.1093/asj/sjz312
  10. Tucunduva MJ, Tucunduva-Neto R, Saieg M, Costa AL, de Freitas C. Vascular mapping of the face: B-mode and doppler ultrasonography study. Med Oral Patol Oral Cir Bucal 2016; 21: e135-41.
  11. Tansatit T, Phumyoo T, Jitaree B, Sawatwong W, Rungsawang C, Jiirasutat N, et al. Ultrasound evaluation of arterial anastomosis of the forehead. J Cosmet Dermatol 2018; 17: 1031-6. https://doi.org/10.1111/jocd.12755
  12. Lee GS. Use of handheld ultrasound Doppler to prevent complications from intra-arterial injection of dermal fillers: clinical experience. J Cosmet Dermatol 2019; 18: 1267-70. https://doi.org/10.1111/jocd.12870
  13. Schelke LW, Decates TS, Velthuis PJ. Ultrasound to improve the safety of hyaluronic acid filler treatments. J Cosmet Dermatol 2018; 17: 1019-24. https://doi.org/10.1111/jocd.12726
  14. Lima VG, Regattieri NA, Pompeu MF, Costa IM. External vascular compression by hyaluronic acid filler documented with high-frequency ultrasound. J Cosmet Dermatol 2019; 18: 1629-31. https://doi.org/10.1111/jocd.12901
  15. Haneke E. Adverse effects of fillers. Dermatol Ther 2019; 32: e12676.
  16. Kassir M, Gupta M, Galadari H, Kroumpouzos G, Katsambas A, Lotti T, et al. Complications of botulinum toxin and fillers: a narrative review. J Cosmet Dermatol 2020; 19: 570-3. https://doi.org/10.1111/jocd.13266
  17. Schelke LW, Velthuis P, Kadouch J, Swift A. Early ultrasound for diagnosis and treatment of vascular adverse events with hyaluronic acid fillers. J Am Acad Dermatol 2023; 88: 79-85. https://doi.org/10.1016/j.jaad.2019.07.032
  18. de Almeida AT, Banegas R, Boggio R, Bravo B, Braz A, Casabona G, et al. Diagnosis and treatment of hyaluronic acid adverse events: Latin American expert panel consensus recommendations. Surg Cosmet Dermatol 2017; 9: 204-13.
  19. DeLorenzi C. Complications of injectable fillers, part 2: vascular complications. Aesthet Surg J 2014; 34: 584-600. https://doi.org/10.1177/1090820X14525035
  20. DeLorenzi C. New high dose pulsed hyaluronidase protocol for hyaluronic acid filler vascular adverse events. Aesthet Surg J 2017; 37: 814-25. https://doi.org/10.1093/asj/sjw251
  21. Lazzeri D, Agostini T, Figus M, Nardi M, Pantaloni M, Lazzeri S. Blindness following cosmetic injections of the face. Plast Reconstr Surg 2012; 129: 995-1012. https://doi.org/10.1097/PRS.0b013e3182442363
  22. Vanaman M, Fabi SG, Carruthers J. Complications in the cosmetic dermatology patient: a review and our experience (part 1). Dermatol Surg 2016; 42: 1-11. https://doi.org/10.1097/DSS.0000000000000569
  23. Rocha LP, de Carvalho Rocha T, de Cassia Carvalho Rocha S, Henrique PV, Manzi FR, E Silva MR. Ultrasonography for long-term evaluation of hyaluronic acid filler in the face: a technical report of 180 days of follow-up. Imaging Sci Dent 2020; 50: 175-80. https://doi.org/10.5624/isd.2020.50.2.175
  24. Lee W, Kim JS, Moon HJ, Yang EJ. A safe doppler ultrasound-guided method for nasolabial fold correction with hyaluronic acid filler. Aesthet Surg J 2021; 41: NP486-92. https://doi.org/10.1093/asj/sjaa153
  25. Urdiales-Galvez F, De cabo-Frances FM, Bove I. Ultrasound patterns of different dermal filler materials used in aesthetics. J Cosmet Dermatol 2021; 20: 1541-8. https://doi.org/10.1111/jocd.14032
  26. Kadouch J, Schelke LW, Swift A. Ultrasound to improve the safety and efficacy of lipofilling of the temples. Aesthet Surg J 2021; 41: 603-12. https://doi.org/10.1093/asj/sjaa066
  27. Desyatnikova S. Ultrasound-guided temple filler injection. Facial Plast Surg Aesthet Med 2022; 24: 501-3. https://doi.org/10.1089/fpsam.2022.0176
  28. Cral WG. The importance of ultrasound in excision of the buccal fat pad. Aesthetic Plast Surg 2022; 46: 1007-8. https://doi.org/10.1007/s00266-021-02497-9
  29. Garcia AS, de Souza MBC, de Albergaria Barbosa JR, Canales GDLT, Oliveria RCG, Rizzatti-Barbosa CM. Treatment protocol for tissue necrosis caused by filling with hyaluronic acid. Int J Health Sci 2022; 2: 1-10.
  30. Hong SO. Cosmetic treatment using botulinum toxin in the oral and maxillofacial area: a narrative review of esthetic techniques. Toxins(Basel) 2023; 15: 82.