Abstract
Purpose
To evaluate ultrasound (US) findings in the cervicofacial area following injection of permanent facial fillers during a long-term follow-up period.
Methods
Fifty-seven consecutive patients with a history of previous facial filler injection were enrolled at a single institution between 2010 and 2014. All patients were female, and the mean age of the patients was 60.8 years. The mean follow-up period following injection of facial fillers was 16.6 years (range 2–30 years). We analyzed US findings in the face (injection site) and neck (noninjection site).
Results
In all patients, face US revealed a snowstorm appearance with strong posterior acoustic shadows and multifocal small anechoic lesions with posterior stepladder artifacts in the subcutaneous fat. Neck US demonstrated the same artifacts as those on the face through local spread of fillers in 14 patients (26.4 %) and abnormal cervical lymph nodes through lymphatic spread in 34 patients (59.6 %). In abnormal cervical lymph nodes, hyperechogenicity and multiple hyperechoic foci were observed in 26 (45.6 %) and 19 (33.3 %) patients, respectively.
Conclusion
Various artifacts may be demonstrated on US in patients with injection of permanent facial fillers. When hyperechogenicity or multiple hyperehoic foci are seen in cervical lymph nodes, the possibility of migration of facial fillers to the cervical area should be considered.
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References
Schelke LW, Van Den Elzen HJ, Erkamp PP, et al. Use of ultrasound to provide overall information on facial fillers and surrounding tissue. Dermatol Surg. 2010;36:1843–51.
Broder KW, Cohen SR. An overview of permanent and semipermanent fillers. Plast Reconstr Surg. 2006;118:7S–14S.
Grippaudo FR, Mattei M. High-frequency sonography of temporary and permanent dermal fillers. Skin Res Technol. 2010;16:265–9.
Smith KC. Reversible vs nonreversible fillers in facial aesthetics: concerns and considerations. Dermatol Online J. 2008;14:3.
Grippaudo FR, Mattei M. The utility of high-frequency ultrasound in dermal filler evaluation. Ann Plast Surg. 2011;67:469–73.
Wortsman X, Wortsman J, Orlandi C, et al. Ultrasound detection and identification of cosmetic fillers in the skin. J Eur Acad Dermatol Venereol. 2012;26:292–301.
Chasan PE. The history of injectable silicone fluids for soft-tissue augmentation. Plast Reconstr Surg. 2007;120:2034–40 (discussion 2041-2033).
Lopez H, Harris KM. Ultrasound interactions with free silicone in a tissue-mimicking phantom. J Ultrasound Med. 1998;17:163–70.
Scanlan KA. Sonographic artifacts and their origins. AJR Am J Roentgenol. 1991;156:1267–72.
Harris KM, Ganott MA, Shestak KC, et al. Silicone implant rupture: detection with US. Radiology. 1993;187:761–8.
Greenleaf JF. Ultrasound: physics and instrumentation. Acad Radiol. 1995;2:S115–7.
Lichtenstein D, Meziere G, Biderman P, et al. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med. 1997;156:1640–6.
Ahuja A, Ying M. Sonography of neck lymph nodes. Part II: abnormal lymph nodes. Clin Radiol. 2003;58:359–66.
Rosario PW, de Faria S, Bicalho L, et al. Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma. J Ultrasound Med. 2005;24:1385–9.
Choi DHB, Choe YH, Park JM, et al. Localized foreign body granulomas of the breast: clinical and mammographic findings. J Korean Radiol Soc. 1998;38:1135–8.
Cho N, Kim EK, Oh KK, et al. Migrated foreign body granulomas on mammography after injection in the cervicofacial area. Clin Radiol. 2004;59:835–40.
Conflict of interest
There are no financial or other relations that could lead to a conflict of interest.
Ethical standards
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
Informed consent
Informed consent was waived in all patients in the study.
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Lee, K.H., Ryu, J., Kim, O. et al. Clinical implications of ultrasound artifacts in the cervicofacial area following injection of permanent facial fillers. J Med Ultrasonics 42, 223–229 (2015). https://doi.org/10.1007/s10396-014-0584-2
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DOI: https://doi.org/10.1007/s10396-014-0584-2