Teixeira Danilo Augusto
Aesthet Surg J Open Forum. 2025 Jun 16;7:ojaf061. doi: 10.1093/asjof/ojaf061. eCollection 2025.
The use of hyaluronic acid (HA) for facial rejuvenation is increasing every year. However, complications can be disastrous because they can cause necrosis, blindness, and stroke. In 2021, the author described a 3-step technique to prevent intravascular injections, but it is time-consuming and difficult to implement.
The aim of the authors of this article is to propose a quicker and simpler ultrasound-guided filling technique using high-frequency ultrasound to avoid intravascular injections.
The investigator introduced a vascular mapping technique that takes <3 min to identify the position of the arteries to introduce the cannula or needle in a different plane. The investigator retrospectively reviewed 503 patients who were injected with 1109 cc of HA utilizing vascular mapping in different areas of the face to evaluate vascular complications.
The most common injection sites were the nasolabial fold (324 cases), marionette lines (157), and lips (106). The chin was injected in 48 patients, the temple in 34, the nose in 26, and the glabella in 23. In 34.7%, 13.2%, and 2.9% of the glabella, nasolabial folds, and temple, respectively, arteries with significant diameters (>0.8 mm) were present at the injection sites. There were no cases of vascular complications.
Except for the glabella, only a small percentage of patients have arteries with larger calibers in the injection area. These arteries can be identified before the procedure using quick Doppler ultrasonography (DUS). The use of DUS to map the site of filler injection can help physicians reduce the risk of intravascular injection.
透明质酸（HA）用于面部年轻化的使用量逐年增加。然而，并发症可能是灾难性的，因为它们可导致坏死、失明和中风。2021年，作者描述了一种预防血管内注射的三步技术，但该技术耗时且难以实施。
本文作者的目的是提出一种更快、更简单的超声引导填充技术，使用高频超声避免血管内注射。
研究者引入了一种血管定位技术，该技术可在<3分钟内确定动脉位置，以便在不同平面引入套管或针头。研究者回顾性分析了503例患者，这些患者在面部不同区域使用血管定位技术注射了1109 cc的HA，以评估血管并发症。
最常见的注射部位是鼻唇沟（324例）、木偶纹（157例）和嘴唇（106例）。48例患者注射了下巴，34例注射了颞部，26例注射了鼻子，23例注射了眉间。在眉间、鼻唇沟和颞部分别为34.7%、13.2%和2.9%的注射部位存在直径较大（>0.8 mm）的动脉。未发生血管并发症病例。
除眉间外，只有一小部分患者在注射区域有较大口径的动脉。这些动脉可在手术前使用快速多普勒超声（DUS）识别。使用DUS对填充剂注射部位进行定位可帮助医生降低血管内注射的风险。
