Facial dermal filler imaging features in ultrasonography: An illustrated systematic review and a guideline for filler identification
DOI:
https://doi.org/10.11606/issn.1679-9836.v105i1e-235693Keywords:
Orofacial, Skin Fillers, Dermal Fillers, Ultrasound Imaging, UltrasonographyAbstract
The objective of this systematic review was to create a comprehensive map of the features of ultrasonographic imaging that can be used to evaluate dermal fillers. Four databases (PubMed CentralÒ, EmbaseÒ, ScopusÒ, and Web of ScienceÒ) were searched using keywords pertaining to ultrasound (US) combined with words that designated dermal fillers, using Boolean operators as follows: “Computer Echotomography” OR “Echotomography” OR “Echography” OR “Ultrasonic Diagnosis” OR “Diagnostic Ultrasound” OR “Ultrasonic Tomography” OR “Medical Sonography” OR “Ultrasonic Imaging” OR “Ultrasound Imaging” OR “Ultrasonographic Imaging” AND “Dermal Filler” OR “Skin Filler” OR “Skin Fillers” OR “Hyaluronic Acid” OR “Injection Fillers” OR “Injection Filler” AND “Face” OR “Lip” OR “Mouth” OR “Mandible” OR “Chin” OR “Mental Region” OR “Maxillofacial Procedures” OR “Zygoma”. A total of 16 observational studies were included, originating from diverse countries such as the United Kingdom, Italy, Spain, Chile, Poland, the United States, Canada, China, Russia, and Brazil. These studies assessed different dermal fillers using ultrasonography in various clinical contexts, providing comparable data for mapping imaging patterns. The dermal fillers evaluated were hyaluronic acid, polyacrylamide hydrogel, polyalkylimide amide, silicone liquid or oil, calcium hydroxyapatite, polymethylmethacrylate-based fillers (PMMA), and autologous fat fillers. Hyaluronic acid and collagen fillers exhibited highly overlapping hypoechoic patterns, whereas PMMA, silicone oil, calcium hydroxyapatite, and polyacrylamide-based fillers demonstrated more distinctive ultrasonographic images, including coarse grain snowfall, acoustic shadowing, or heterogeneous hyperechogenicity. In conclusion, the identification of dermal fillers is complex. The distinct patterns exhibited by some dermal fillers can be effectively detected by US imaging, while others present overlapping imaging features
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Copyright (c) 2026 Maria Fernanda Rabelo Thomaz, Alexia Victória Klassen, Isabelle Tomelin Rothenburg, Tabada Deusdado Bertani, Bruno Lucena Antunes Abrantes, Claudio Fróes de Freitas, Emiko Saito Arita, Plauto Christopher Aranha Watanabe, Yeda da Silva, LUCIANA MUNHOZ, Gabriel Colla Cordasso
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