Division of Plastic Surgery.
Department of Radiology, Mayo Clinic; Rochester, MN.
J Craniofac Surg. 2021 May 1;32(3):e276-e278. doi: 10.1097/SCS.0000000000007196.
Dermal filler injections, one of the most commonly performed procedures in facial esthetic surgery, are rising in popularity. This has also led to an increase in nonmedical grade filler injections performed by nonmedical personnel, including that of injectable silicone. Surgical removal of silicone fillers is challenging, as the hydrophobic material often disperses within the soft tissue as droplets. This can lead to a systemic inflammatory reaction requiring steroid treatment. MRI localization of the filler material does not enable intraoperative guidance, and palpitation of the material is challenging since the filler droplets are often too small to palpate and located in multiple planes. We present a case demonstrating the advantages of utilizing intraoperative ultrasound to localize and silicone filler material. Utilizing this technique, we were able to achieve a high degree of excision of silicone filler material and the patient was able to stop her previous necessary immunosuppressive steroid regimen successfully.
真皮填充剂注射是面部美容手术中最常见的程序之一，其受欢迎程度日益增加。这也导致非医务人员进行的非医用级填充物注射增加，包括注射用硅胶。由于疏水性材料通常以液滴形式散布在软组织中，因此手术切除硅胶填充物具有挑战性。这可能导致需要类固醇治疗的全身性炎症反应。填充物材料的 MRI 定位不能实现术中引导，并且由于填充物液滴通常太小而无法触诊，并且位于多个平面中，因此触诊材料也具有挑战性。我们提出了一个病例，展示了利用术中超声定位和硅胶填充材料的优势。利用该技术，我们能够实现硅胶填充材料的高度切除，并且患者能够成功停止以前必需的免疫抑制性类固醇治疗方案。
