HIGH-RESOLUTION ULTRASOUND OF COSMETIC THREADS AFTER THEIR IMPLANTATION INTO THE SOFT TISSUES OF THE FACE AND NECK

Abstract

Objective To optimize the process of diagnostics of cosmetic threads using the high-resolution ultrasound. Material and Methods 80 women were examined with high-resolution ultrasound after implantation of cosmetic threads made of absorbable and non-absorbable materials into the soft tissues of the face and neck. Threads based on the L-lactide-co-ԑ-caprolactone were implanted in 36 cases (45%), threads produced from silicone-sheathed polyester fiber were used for 7 (8.8%) patients, from polydioxanone for 17 (21.2%) patients, from L-lactic acid for 14 (17.5%) patients, polypropylene threads were implanted in 5 (6.3%) patients, gold threads were applied only in one case (1.2%). Patients complained of overcorrection in 10 cases, inflammatory complications in 10 cases as well, and inquired about the presence of the threads in soft tissues in 60 cases. Results Ultrasound feature of non-absorbable threads made of silicone-sheathed polyester fiber is a heterogeneous structure with a hypoechoic center and hyperechoic margins. Inflammation around the threads is accompanied by perifocal edema in the form of a zone of reduced echogenicity. The presence of an acoustic shadow is a differential feature that distinguishes threads from the ligamentous apparatus of the skin. Effect of reverberation is a specific feature for metal threads. Conclusion If threads are found in the implantation area, it is necessary to carry out differential diagnostics of the ligamentous apparatus, septa, and superficial fascia of the face. The methodological features lied in the fact that ultrasound diagnostics should be performed in multiple views with necessary visualization in the transverse and longitudinal sections of the studied object using the high-frequency sensors in B-mode, as well as the Doppler technology and compression elastography.