Ultrasound is not only being used to evaluate the unborn baby in a clinical setting but its use has been expanded into the cosmetic sector to assist with the safe administration of dermal filler and botulin injections.
Injection of cosmetic fillers is one of the most commonly performed procedures in dermatology nowadays. Hyaluronic acid fillers are known for a reliable safety profile but as its usage is increasing, complications are also increasing, including serious vascular adverse events.
Ultrasonography can assist in identifying previous fillers as well as assisting in the evaluation and follow-up of possible adverse effects.
Why is ultrasound used to assist with filler injections?
The face is full of blood vessels and every time an injection is carried out, the filler is delivered into tissues where the vessels lie. With ultrasound/duplex examination, skin, the underlying tissue including muscles, veins, and arteries can be made visible resulting in improvement of the safety of dermal filler treatments.
How does ultrasound help deliver safer injections?
Ultrasound can map out the location of the larger blood vessels in the face, so the injector can avoid these vessels during the treatment. This is known as an ultrasound-guided injection and in the unlikely event of vascular occlusion, the surgeon can correct immediately with Hyaluronidase.
Identifying the precise location to place the injections is another advantage of using ultrasound that helps to achieve very nice, natural and pleasing results.
Evaluate filler complications that aren’t necessarily vascular-related, such as nodules, granulomas or just swelling related to filler.
Ultrasound can be used for injections around the nose, which is highly vascular and injections in the wrong place can cause blindness.
What areas is ultrasound used for?
Injections in temples, forehead, noses, nose to mouth lines and lips most commonly, as these, can be high-risk areas. There is a perception amongst the novice injectors that lip injections or nose to mouth line area are easy. In reality, this can be a very tricky treatment to get right and there is a high risk of complications here because of the variations in anatomy.
Injections into muscles such as the jaw clenchers for treatments of bruxism and teeth grinding. Precise placement into the muscle is necessary for the treatment to work well.
For dissolving fillers if they have not been placed properly or if they are causing pressure or blockage of blood vessels.
The Ultrasound Scanner
An ultrasound device consists of a probe and a processor. The probe will generate a sound wave that penetrates body tissue. Sound waves interact with the tissue and become progressively weaker in strength as the waves are absorbed or scattered. Part of the sound waves is being reflected. The reflected sound waves, picked up by the probe and directed to the processor, are transformed into a digital image.
When a Doppler is integrated with the ultrasound, the device is named duplex. With a duplex machine, blood flow is made visible on the screen in red and blue colours. Blood vessels therefore can be identified in conjunction with other dermal structures.
What are the specifications of the ultrasound scanner you need?
These are our recommended specifications of the ultrasound machine to assist you with the safe administration of dermal fillers.
Resolution
The ultrasound scanner should be of high resolution to help you identify the superficial structures easier and improve confidence
Ultrasound probe
Frequency
High frequency (12-17 MHz) for superficial structure.
Shape/size of the transducer
– Linear
– Hockey stick
Laptop or Smartphone Ultrasound Scanner?
Ultrasonic technology has significantly improved these days, and you can achieve exceptional image quality with a smartphone ultrasound scanner. A laptop ultrasound will however offer in most cases significant improvement in resolution.
Colour Doppler
Colour Doppler will help you differentiate blood vessels from the adjacent structures and will increase diagnostic confidence.
Training to use the ultrasound scanner?
Choosing the best ultrasound scanner to be use in cosmetic surgery is only part of the journey and training should be an integral part of the purchase. Training will not only guarantee the safe use of the scanner but will also help you to achieve the best image quality.
It is very common for a cosmetic surgeon to buy a suboptimal scanner from eBay only to find out that the image quality is suboptimal, and that they are unable to use it properly.
Service and Warranty
Ultrasound scanners are very reliable these days, but unexpected faults can occur, resulting in disturbance of your workflow. It is important therefore that your scanner is regularly serviced and the vendor response time to any breakdowns is quick.
Best ultrasound scanners for fillers
The following ultrasound scanners have been clinically evaluated, and they suitable to be used in cosmetic medicine.
Please contact us with any questions you might have.
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