Wortsman Ximena, Valderrama Yessenia, Ortiz-Orellana Gabriela, Gonzalez Claudia, de Cabo Francisco, Desyatnikova Stella, Cavallieri Fernanda Aquino, Barrera Patricia, Sigrist Rosa
Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile.
Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
J Ultrasound Med. 2025 Aug;44(8):1447-1455. doi: 10.1002/jum.16700. Epub 2025 Apr 5.
To provide insight into the characteristics, layer locations, and corporal distribution of the granulomatous reactions to cosmetic fillers.
An international retrospective multicentric study was performed in centers that scan complications of cosmetic fillers. Inclusion criteria were patients with previous injections of known cosmetic fillers confirmed by ultrasound and ultrasonographic features of granulomatous reactions such as hypoechoic nodules, pseudonodules, or hypoechoic tissue surrounding the deposit regions. The ultrasound studies followed the published guidelines for performing dermatologic ultrasound examinations.
A total of 240 cases met the criteria. The leading fillers previously injected were 50.4% hyaluronic acid, 18.8% poly-L-lactic acid, 8.3% polymethylmethacrylate, 6.3% calcium hydroxyapatite, and 3.8% silicone oil. The main regions of granulomas were the lower lid, infraorbital, and medial cheek in 41.7%, the perioral region and lips in 19.2%, the lateral jaw and cheek in 14.6%, and the chin, pre-jowl, and medial jaw in 12.5%. The layers involved by the granulomatous reaction were hypodermis in 37.1%, the deep fat pad in 8.9%, the periosteum in 5.8%, the combination of hypodermis, deep fat pad, and muscle in 5.8%, and the combination of hypodermis, fascia, subfascial, deep fat pad, and muscle in 5.4%. The predominant corporal locations were the face, submandibular, and anterior neck, with 95.8% being 87.5% in the face.
Ultrasound can provide valuable and detailed anatomical information supporting diagnosis and management as well as valuable insights into the granulomatous reactions to fillers.
深入了解对美容填充剂肉芽肿反应的特征、层次位置和身体分布情况。
在对美容填充剂并发症进行扫描的中心开展一项国际回顾性多中心研究。纳入标准为经超声证实曾注射过已知美容填充剂且具有肉芽肿反应超声特征（如低回声结节、假结节或沉积物区域周围的低回声组织）的患者。超声检查遵循已发表的皮肤科超声检查指南。
共有240例符合标准。先前注射的主要填充剂分别为：透明质酸50.4%、聚左旋乳酸18.8%、聚甲基丙烯酸甲酯8.3%、羟基磷灰石钙6.3%、硅油3.8%。肉芽肿的主要部位为下眼睑、眶下和颊内侧，占41.7%；口周区域和嘴唇，占19.2%；下颌外侧和颊部，占14.6%；下巴、颌前和下颌内侧，占12.5%。肉芽肿反应累及的层次为皮下组织占37.1%、深部脂肪垫占8.9%、骨膜占5.8%、皮下组织、深部脂肪垫和肌肉联合占5.8%、皮下组织、筋膜、筋膜下、深部脂肪垫和肌肉联合占5.4%。主要身体部位为面部、颌下和颈前部，其中95.8%位于面部，面部中87.5%位于该部位。
超声可提供有价值的详细解剖信息，支持诊断和管理，还能深入了解对填充剂的肉芽肿反应。
