Download PDF
CC BY 4.0 · Arch Plast Surg 2023; 50(04): 348-353
DOI: 10.1055/s-0043-1770078
Cosmetic
Review Article

Hyaluronic Acid Filler Injection Guided by Doppler Ultrasound

Won Lee 
1   Yonsei E1 Plastic Surgery Clinic, Anyang, South Korea
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Doppler ultrasound can be used to detect almost all arteries of the face before injecting the hyaluronic acid (HA) filler. The relatively more dangerous sites of filler injection are the glabellar wrinkle, forehead, temple, nose, and nasolabial fold area, and it is recommended to map the vasculature of these areas by Doppler ultrasound before performing filler injection. The Doppler ultrasound detection method is included as a video. Internal carotid arterial branches, the supratrochlear, supraorbital, and dorsal nasal arteries, and external carotid arterial branches, the superficial temporal and facial arteries, are very important arteries when injecting HA filler; thus, Doppler ultrasound detection is recommended.

Keywords

soft tissue filler - hyaluronic acid filler - ultrasound - filler complication

Authors' Contributions

W.L. has made contribution to conceptualization, writing, and drafting. the author is in change of every section of the manuscript.


Ethical Approval

Since it is a Review, Ethical Approval was not required for this article.


Patient Consent

All photograph model provided written consent for publication.




Publication History

Received: 03 September 2022

Accepted: 24 March 2023

Article published online:
02 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 The aesthetic society's cosmetic surgery national data bank: Statistics 2019. Aesthet Surg J 2020; 40 (1, suppl 1): 1-26
    CrossrefPubMedGoogle Scholar
  • 2 DeLorenzi C. Complications of injectable fillers, part I. Aesthet Surg J 2013; 33 (04) 561-575
    Google Scholar
  • 3 DeLorenzi C. Complications of injectable fillers, part 2: vascular complications. Aesthet Surg J 2014; 34 (04) 584-600
    CrossrefPubMedGoogle Scholar
  • 4 Kim HJ, Youn KH, Kim JS, Kim YS, Hong SO, Na J. Ultrasonographic Anatomy of the Face and Neck for Minimally Invasive Procedures: An Anatomic Guideline for Ultrasonographic-Guided Procedures. Singapore: Springer Nature; 2020
    Google Scholar
  • 5 Schelke LW, Decates TS, Velthuis PJ. Ultrasound to improve the safety of hyaluronic acid filler treatments. J Cosmet Dermatol 2018; 17 (06) 1019-1024
    CrossrefPubMedGoogle Scholar
  • 6 Rocha PS, Guerra TA, Teixeira DA. Description of a safe Doppler ultrasound-guided technique for hyaluronic acid filler in the face-a method to avoid adverse vascular events. J Cosmet Dermatol 2022; 21 (07) 2783-2787
    CrossrefPubMedGoogle Scholar
  • 7 Beleznay K, Carruthers JD, Humphrey S, Jones D. Avoiding and treating blindness from fillers: a review of the world literature. Dermatol Surg 2015; 41 (10) 1097-1117
    CrossrefPubMedGoogle Scholar
  • 8 Lee W, Moon HJ, Kim JS, Yang EJ. Safe glabellar wrinkle correction with soft tissue filler using Doppler ultrasound. Aesthet Surg J 2021; 41 (09) 1081-1089
    CrossrefPubMedGoogle Scholar
  • 9 Lee W. Five factors to consider before treatment of a hyaluronic acid filler-induced vascular complications. Arch Plast Surg 2022; 49 (04) 479-481
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Cong LY, Phothong W, Lee SH. et al. Topographic analysis of the supratrochlear artery and the supraorbital artery: implication for improving the safety of forehead augmentation. Plast Reconstr Surg 2017; 139 (03) 620e-627e
    CrossrefPubMedGoogle Scholar
  • 11 Phumyoo T, Jiirasutat N, Jitaree B, Rungsawang C, Pratoomthai B, Tansatit T. Localization and topography of the arteries on the middle forehead region for eluding complications following forehead augmentation: conventional cadaveric dissection and ultrasonography investigation. J Craniofac Surg 2020; 31 (07) 2029-2035
    CrossrefPubMedGoogle Scholar
  • 12 Davidge KM, van Furth WR, Agur A, Cusimano M. Naming the soft tissue layers of the temporoparietal region: unifying anatomic terminology across surgical disciplines. Neurosurgery 2010; 67 (3, Suppl Operative): ons120-ons129 , discussion ons129–ons130
    PubMedGoogle Scholar
  • 13 Lee W, Park JW, Yang EJ. Temple augmentation by injecting a hyaluronic acid filler between the superficial and deep temporal fasciae. J Cosmet Dermatol 2022; 21 (10) 4313-4318
    CrossrefPubMedGoogle Scholar
  • 14 Lee W, Moon HJ, Kim JS, Chan BL, Yang EJ. Doppler ultrasound-guided thread lifting. J Cosmet Dermatol 2020; 19 (08) 1921-1927
    CrossrefPubMedGoogle Scholar
  • 15 Swift A. One up, one over regional approach in upper face: anatomy and regional approaches to injectables” found in the November 2015 supplement issue soft tissue fillers and neuromodulators: international and multidisciplinary perspectives. Plast Reconstr Surg 2015; 136: S204-S218
    Google Scholar
  • 16 Lee W, Moon HJ, Kim MS, Cheon GW, Yang EJ. Pre-injection ultrasound scanning for treating temporal hollowing. J Cosmet Dermatol 2022; 21 (06) 2420-2425
    CrossrefPubMedGoogle Scholar
  • 17 Beleznay K, Carruthers JDA, Humphrey S, Carruthers A, Jones D. Update on avoiding and treating blindness from fillers: a recent review of the world literature. Aesthet Surg J 2019; 39 (06) 662-674
    CrossrefPubMedGoogle Scholar
  • 18 Moon HJ. Injection rhinoplasty using filler. Facial Plast Surg Clin North Am 2018; 26 (03) 323-330
    CrossrefPubMedGoogle Scholar
  • 19 Lee W, Kim JS, Oh W, Koh IS, Yang EJ. Nasal dorsum augmentation using soft tissue filler injection. J Cosmet Dermatol 2019; 18 (05) 1254-1260
    CrossrefPubMedGoogle Scholar
  • 20 Choi DY, Bae JH, Youn KH. et al. Topography of the dorsal nasal artery and its clinical implications for augmentation of the dorsum of the nose. J Cosmet Dermatol 2018; 17 (04) 637-642
    CrossrefPubMedGoogle Scholar
  • 21 Moon HJ, Lee W, Do Kim H, Lee IH, Kim SW. Doppler ultrasonographic anatomy of the midline nasal dorsum. Aesthetic Plast Surg 2021; 45 (03) 1178-1183
    CrossrefPubMedGoogle Scholar
  • 22 Thanasarnaksorn W, Cotofana S, Rudolph C, Kraisak P, Chanasumon N, Suwanchinda A. Severe vision loss caused by cosmetic filler augmentation: case series with review of cause and therapy. J Cosmet Dermatol 2018; 17 (05) 712-718
    CrossrefPubMedGoogle Scholar
  • 23 Lee JG, Yang HM, Choi YJ. et al. Facial arterial depth and relationship with the facial musculature layer. Plast Reconstr Surg 2015; 135 (02) 437-444
    CrossrefPubMedGoogle Scholar
  • 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 (06) NP486-NP492
    CrossrefPubMedGoogle Scholar
  • 25 Kim YS, Choi DY, Gil YC, Hu KS, Tansatit T, Kim HJ. The anatomical origin and course of the angular artery regarding its clinical implications. Dermatol Surg 2014; 40 (10) 1070-1076
    CrossrefPubMedGoogle Scholar
  • 26 Calomeni M, Alfertshofer MG, Frank K. et al. Real-time ultrasound imaging of the tear trough: lessons learned from functional anatomy. Aesthet Surg J 2022; 42 (05) 518-526
    CrossrefPubMedGoogle Scholar