TEXT / CALL 678-974-8435
Ultrasound is a non-invasive imaging technology that uses sound waves to create images of structures beneath the skin. It is widely used throughout medicine to evaluate soft tissues, organs, blood vessels, and other anatomy without radiation.
In aesthetic medicine, high-resolution ultrasound can provide additional information about the tissues beneath the skin and may be helpful when evaluating patients who have previously undergone facial filler injections.
At Aviva Plastic Surgery, Dr. Inessa Fishman has completed specialized training in the use of ultrasound for facial aesthetic applications. As an experienced head and neck surgeon and facial plastic surgeon, she also brings extensive knowledge of facial anatomy and experience with facial surgery to the interpretation of ultrasound findings.
Hyaluronic acid (HA) fillers are commonly used to restore facial volume, enhance facial contours, and soften lines and folds. Occasionally, patients may develop concerns after filler treatment, including persistent fullness, asymmetry, contour irregularities, swelling, or an aesthetic result they no longer desire.
High-resolution ultrasound can be a useful tool when evaluating these concerns. Depending on the individual situation, ultrasound may help Dr. Fishman:
Importantly, ultrasound is not a simple “filler present” or “filler absent” test. Ultrasound findings require clinical interpretation and must be considered alongside a patient’s examination, treatment history, symptoms, and previous procedures.
The appearance of previously injected material can vary depending on the type of filler, how and where it was injected, how long it has been present, previous dissolving treatments, and changes within the surrounding tissues. In some cases, ultrasound may not provide a definitive explanation for a patient’s symptoms or concerns.
When unwanted hyaluronic acid filler is believed to be contributing to a patient’s concern, hyaluronidase may be used to dissolve it. Hyaluronidase is an enzyme that breaks down hyaluronic acid.
Ultrasound may be helpful in selected cases by allowing Dr. Fishman to better understand the location and depth of suspected filler and, when appropriate, to guide treatment toward a specific area.
However, not every concern following filler injection is caused by residual filler, and not every patient benefits from additional dissolving. Swelling, scar tissue, normal anatomy, tissue changes from previous surgery, and other factors can sometimes contribute to a patient’s appearance or symptoms.
For this reason, Dr. Fishman first evaluates the patient’s history, anatomy, previous treatments, and clinical findings before determining whether ultrasound imaging or hyaluronidase treatment may be appropriate.
Malar edema refers to swelling of the upper cheek and lower eyelid region. It can have multiple causes and may occur in patients who have undergone facial filler injections, facial surgery, or other aesthetic treatments.
Ultrasound may sometimes provide useful additional information when evaluating persistent swelling in this area. It can help visualize the soft tissues beneath the skin and may assist Dr. Fishman in determining whether previously placed filler could be contributing to the clinical picture.
As with other filler-related concerns, ultrasound findings alone cannot necessarily determine the cause of facial swelling. A thorough clinical evaluation remains essential.
Dr. Fishman has specialized training in facial ultrasound imaging as well as extensive experience in head and neck anatomy, facial plastic surgery, and injectable treatments. She uses ultrasound selectively as an additional diagnostic and treatment tool when she believes it may provide meaningful information.
Ultrasound does not guarantee that filler will be identified, that a patient’s symptoms are caused by filler, or that dissolving filler will resolve a particular concern. In some cases, Dr. Fishman may recommend observation, additional medical evaluation, or no further filler treatment rather than additional dissolving.
Because concerns involving filler placed by other providers can be complex, Aviva Plastic Surgery accepts a limited number of patients for evaluation of previously placed filler. These consultations are intended for non-urgent concerns and require an individualized assessment before ultrasound imaging or treatment is recommended.