Velthuis P J, Alfageme F, Cartier H, Cassuto D, Catalano O, Cavallieri F, Desyatnikova S, Gonzalez Diaz C P, Kim J S, Mandava A, Mariluis C, Schelke L S, Shah-Desai S, Weiner S, Wortsman X
Department of Dermatology, Erasmus Medical Center, Rotterdam, the Netherlands.
Dermatology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
J Plast Reconstr Aesthet Surg. 2025 May;104:33-37. doi: 10.1016/j.bjps.2025.03.001. Epub 2025 Mar 12.
A four-round modified Delphi consensus was held concerning the question, 'What are the prerequisites for using ultrasound imaging in cosmetic filler injections'? Fifteen international experts in the field from seven different relevant medical specialties and 11 countries were included. An extensive list of topics was discussed in rounds 1 and 2. Statements were drawn up for voting in rounds 3 and 4. Experts had a consensus (>70% agreement) on most of the statements. With regard to equipment, a minimum linear 15 MHz transducer (probe) is recommended for both learning and regular diagnostics. Hand-held devices can be used in both circumstances. B-mode, Color-Doppler, Spectral Doppler, and picture/video archiving are mandatory, Power-Doppler is recommended. Experts find ultrasound imaging prior to injection mandatory in certain areas with high risk for vascular adverse events, as well as for the management of complications. It is recommended to identify prior fillers before injecting. An ultrasound-guided injection is recommended in many parts of the face for fillers, toxin and injection lipolysis. A sterile probe cover and sterile gel are necessary in these cases. Ultrasound-guidance is necessary for precise intralesional injections, needed in filler complication treatment. An extensive list of training and practice topics is given that should be learned before one can start using ultrasound imaging in cosmetic filler injection practice. Ultrasound imaging for minimal invasive aesthetic procedures has met a significant surge in attention, both in publication numbers and in prominence at major conferences. For physicians and institutions exploring this field, many critical decisions must be made, particularly concerning the prerequisites for using ultrasound imaging in cosmetic filler injections. Guidelines from international experts addressing these topics would provide valuable insights and facilitate the adoption of ultrasound technology in this field.
针对“在美容填充注射中使用超声成像的前提条件是什么”这一问题，举行了四轮改进的德尔菲共识会议。来自七个不同相关医学专业、11个国家的15名国际领域专家参与其中。在第一轮和第二轮中讨论了一系列广泛的主题。在第三轮和第四轮中起草了声明供投票。专家们对大多数声明达成了共识（>70%的同意率）。关于设备，建议学习和常规诊断时均使用至少15MHz的线性换能器（探头）。两种情况下均可使用手持设备。B模式、彩色多普勒、频谱多普勒以及图像/视频存档是必需的，建议使用能量多普勒。专家们认为，在某些血管不良事件高风险区域注射前以及处理并发症时，超声成像必不可少。建议在注射前识别先前的填充物。对于面部许多部位的填充物、毒素和注射溶脂，建议采用超声引导注射。在这些情况下，需要无菌探头套和无菌凝胶。对于填充剂并发症治疗中所需的精确病灶内注射，超声引导是必要的。给出了一份广泛的培训和实践主题清单，在开始在美容填充注射实践中使用超声成像之前应学习这些内容。微创美容手术的超声成像在发表数量和在主要会议上的受关注程度方面都显著增加。对于探索该领域的医生和机构而言，必须做出许多关键决策，尤其是关于在美容填充注射中使用超声成像的前提条件。国际专家针对这些主题制定的指南将提供有价值的见解，并促进该领域超声技术的应用。
