My journey with ultrasound began more than 20 years ago as an Intensive Care Nurse Practitioner. In critical care, ultrasound was an essential part of daily practice. We used it for FAST exams, central line placement, paracentesis, thoracentesis, and bedside assessments. It helped us make better clinical decisions and improve patient safety.

During that time, I also trained in dermatology, plastic surgery, and aesthetic medicine. When I transitioned to aesthetics full-time more than a decade ago, I often thought about how valuable ultrasound could be in helping us better understand facial anatomy and improve treatment outcomes. That idea was reinforced when I met Dr. Peter Velthuis and Dr. Steven Weiner at IMCAS. Their discussions about incorporating facial ultrasound into aesthetic medicine inspired me to learn more. What started as curiosity quickly became a passion.

I attended training around the world and ultimately pursued my Doctor of Nursing Practice degree with a focus on facial ultrasound. Working with Dr. Velthuis as my preceptor and dissertation chair, we published research in the _Journal of the American Academy of Dermatology (JAAD)_ evaluating the impact of pre-procedural ultrasound scanning on bruising outcomes in dermal filler treatments. Our study found that patients who underwent ultrasound assessment before treatment experienced significantly less bruising than those who did not. Seventy percent of patients in the ultrasound group had no visible bruising compared with only 28.8% in the control group. These findings provided evidence that better visualisation of vascular anatomy can improve patient outcomes and support safer treatment planning.

Since incorporating ultrasound into my practice, I have used it to evaluate filler placement, manage complications, and assist providers both locally and remotely with challenging cases. I've also seen an increasing number of patients seek out ultrasound-guided care because they value the additional layer of information and safety it provides.

One case that particularly stands out involved a patient who was referred to me by a plastic surgeon colleague. She had undergone lip filler treatment approximately six months earlier and developed acute swelling and firm nodules in her lips following a viral illness. The plastic surgeon had already attempted treatment with multiple vials of hyaluronidase, but there was little to no improvement.

Based on the clinical presentation, I recommended a course of doxycycline and performed an ultrasound evaluation. Ultrasound allowed us to identify persistent filler within the affected areas and better understand the extent of the inflammatory process. We proceeded with ultrasound-guided hyaluronidase treatment, which was challenging because the filler had formed very firm nodules, making needle placement difficult. However, ultrasound enabled precise targeting of the remaining filler deposits that would have been difficult to locate and treat blindly. The patient ultimately required two treatment sessions over a two-week period. In addition to ultrasound-guided hyaluronidase, we utilised a second course of corticosteroids and antihistamines to address the inflammatory response. Through a combination of medical management, ultrasound-guided treatment, and close follow-up, the swelling and nodules resolved successfully. Most importantly, the patient was able to attend an important upcoming event feeling comfortable and confident again.

Cases like this remind me that ultrasound is not just about technology; it's about improving patient care and supporting clinical decision-making. They also highlight the value of collaboration. The successful outcome was not the result of one provider working in isolation, but rather a team approach involving multiple clinicians working toward the best outcome for the patient. Cases like this reinforce the value of collaboration and multidisciplinary problem-solving in achieving the best outcomes for our patients. Experiences like these are why I believe ultrasound is becoming increasingly important—not only in clinical practice, but also in research.

As ultrasound becomes more widely adopted in aesthetic medicine, we need evidence to better understand its impact on patient outcomes, safety, and decision-making. Research helps move the conversation beyond anecdotal experience and provides the data needed to support best practices and guide future innovation.

Today, I am serving as Principal Investigator for a multicenter study titled _Impact of Ultrasound Use on Patient-Perceived Safety, Risk Perception, and Decision-Making in Aesthetic Injectable Treatments_. This study explores how the use of ultrasound influences patient confidence, perceptions of safety, and treatment decisions. While we have growing evidence demonstrating the clinical benefits of ultrasound, understanding the patient's perspective is equally important.

One of the most rewarding parts of this journey has been education. I currently teach facial ultrasound independently and for Cutaneous, working with providers who are interested in bringing ultrasound into their practices. One message I consistently share is that ultrasound does not have to be overwhelming. Like any skill, it starts with learning the fundamentals and building confidence through practice. One of the most rewarding aspects of teaching is watching providers gain confidence, strengthen their understanding of anatomy, and discover how ultrasound can enhance patient care.

As a profession, we all share the same goal: improving outcomes and advancing patient safety. Ultrasound is simply another tool that helps us move toward that goal. The more we learn from one another, contribute to research, and share our experiences, the stronger our specialty becomes.

Looking back, what began as a familiar tool from my critical care days has become an integral part of my aesthetic practice, research, and teaching. More importantly, it has connected me with a community of colleagues committed to advancing our profession. I believe the future of facial ultrasound will be shaped not by a few experts but by the many providers willing to learn, share their experiences, and help move our field forward together.