Integrating facial ultrasound into medical esthetics practice

J Am Acad Dermatol. 2025 Dec;93(6):1526-1528. doi: 10.1016/j.jaad.2025.05.1428. Epub 2025 May 30.

Abstract

Background: The increasing prevalence of dermal filler procedures has highlighted the need for enhanced visualization techniques to optimize outcomes and reduce complications.

Objective: To evaluate the impact of preprocedural ultrasound scanning on bruising outcomes in dermal filler treatments.

Methods: This prospective quality improvement study compared bruising outcomes between patients who received preprocedural ultrasound scanning (intervention group, n = 80) versus standard care (control group, n = 80) at a single center. The Bruising Visibility Scale was used to assess outcomes. Three experienced providers performed all procedures following standardized protocols, using a MindRay 16 MHz ultrasound device for the intervention group.

Results: Chi-square analysis revealed a statistically significant reduction in bruising incidence with preprocedural ultrasound scanning (χ2 = 29.928, P < .05). The intervention group demonstrated significantly higher rates of bruise-free outcomes (70% vs 28.8%, odds ratio = 5.77, 95% confidence interval: 2.98-11.18).

Limitations: Single-center design and immediate postprocedure assessment timepoint.

Conclusion: Preprocedural ultrasound scanning significantly reduces bruising in dermal filler procedures, suggesting improved vascular visualization may enhance procedural outcomes. These findings provide quantitative evidence supporting the integration of ultrasound guidance in esthetic practice.

Keywords: bruising; dermal fillers; doppler ultrasound; esthetic medicine; facial ultrasound; injection complications.

MeSH terms

  • Adult
  • Contusions* / diagnostic imaging
  • Contusions* / epidemiology
  • Contusions* / etiology
  • Contusions* / prevention & control
  • Cosmetic Techniques* / adverse effects
  • Dermal Fillers* / administration & dosage
  • Dermal Fillers* / adverse effects
  • Esthetics
  • Face* / diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality Improvement
  • Ultrasonography
  • Ultrasonography, Interventional* / methods

Substances

  • Dermal Fillers