Ultrasound imaging in filler complications

Ultrasound devices have become accessible and necessary devices in aesthetic clinics. In this chapter, the multidisciplinary group of specialized physicians working in the Filler Complications Unit at the Erasmus Medical Center outpatient department of dermatology is sharing important insights in prevention and management of soft tissue filler complications. For ultrasound guided injections there must be a straight line from physician to the ultrasound monitor with in the middle the patient's problem area covered by the ultrasound probe. The needle to deliver the hyaluronidase needs to be thick enough to be detected by the ultrasound device. Portable ultrasound machines with 10-12 MHz probes are available for less than 10.000 euro/dollars. These offer good quality imaging of the first 4-6 cm under the skin surface. The color doppler (duplex mode) enables to detect bidirectional blood flow.