Abstract
High-resolution ultrasound (HRU) imaging is a useful tool to study hyaluronic acid (HA) filler injection in the face. It is noninvasive, quick, well-tolerated, and can provide in vivo and dynamic information. The formations of pools or pearls in HA fillers could be observed real time during injection. The plane of injection could be determined accurately, and there were no specimen manipulation artifacts. It was observed that HA gel fillers with differing production technologies showed distinct spread and distribution patterns in the periocular tissues on HRU examination. The authors used HRU to assess deep injections of CHAP-Hyaluronic Acid (CHAP-HA) fillers for midface lift. 10 patients who underwent bilateral midface deep injections using CHAP-HA filler were examined with HRU before and immediately after treatment, and in 2 weeks and one month later. The CHAP-HA appeared as hypoechoic densities within the preperiosteal plane in HRU. CHAP-HA adopted variable morphology within the tissue depending on individual tissue densities and the compliance of the tissues in the plane of injection. CHAP-HA was unidentifiable with surrounding tissue after one month in 13 of the 20 injection sites. HRU allows in vivo study of CHAP-HA injection behavior and could be a tool for further studies of HA-tissue reactions.
Highlights
High-resolution ultrasound (HRU) made the visualization of hyaluronic acid (HA) filler possible within the facial soft tissues, providing perspectives on the shape, size, and location of the HA when injected [1]-[6]
The authors used HRU to assess deep injections of CHAP-Hyaluronic Acid (CHAP-HA) fillers for midface lift. 10 patients who underwent bilateral midface deep injections using CHAP-HA filler were examined with HRU before and immediately after treatment, and in 2 weeks and one month later
All subjects received a single-point injection of 1ml CHAP-HA (HYADERMISTM Smile) on each side of the midface region. 6 subjects chose to be injected with sharp needle, whereas 4 subjects decided to be injected with microcannula
Summary
High-resolution ultrasound (HRU) made the visualization of hyaluronic acid (HA) filler possible within the facial soft tissues, providing perspectives on the shape, size, and location of the HA when injected [1]-[6]. It could be a useful tool to study HA-tissue interactions and is generally well-tolerated. This may be especially helpful during periorbital injections, where thin skin overlies bone and the complex three-dimensional contours are challenging [7]. Goh et al reported that HA gel fillers with differing production technologies showed distinct spreads and distribution patterns in the periocular tissues on HRU examination [9]. Such variability could be the results of the interactions between the injection techniques, HA particles, plane of injections, and individual tissue compliance
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