Aesthetics research

PMID: 42285862

Ultrasound Med Biol. 2026 Jun 12:S0301-5629(26)00201-2. doi: 10.1016/j.ultrasmedbio.2026.05.015. Online ahead of print.

ABSTRACT

Ultrasound has emerged as a versatile, non-invasive imaging technique in dermatology, offering real-time, high-resolution visualization of cutaneous structures. By employing high- and ultra-high-frequency probes, skin ultrasound enables detailed assessment of the epidermis, dermis, and subcutaneous tissue, while Doppler modalities provide complementary information on vascularity. This review synthesizes current evidence on the role of ultrasound across the spectrum of dermatologic conditions, including malignant and benign tumors, inflammatory skin disorders, connective tissue diseases, and cosmetic interventions. In skin cancer, high-frequency ultrasound supports preoperative planning by estimating lesion depth, margins, and risk stratification, with particular value in basal cell carcinoma, squamous cell carcinoma, and melanoma. In benign tumors such as epidermal cysts and lipomas, sonographic features help avoid unnecessary invasive procedures. Ultrasound also refines disease staging and monitoring in chronic inflammatory dermatoses, notably hidradenitis suppurativa, psoriasis and psoriatic arthritis, while enabling quantification of fibrotic involvement in systemic sclerosis and morphea, besides assessing the degree of inflammatory activity. Beyond clinical dermatology, ultrasound provides critical guidance in aesthetic medicine, enhancing the safety and precision of filler injections and facilitating early detection and management of complications. Recent advances include integration with dermoscopy, and artificial intelligence for automated disease classification, which promise to reduce operator dependency and improve reproducibility. Taken together, these findings highlight the pivotal role of skin ultrasound as a diagnostic and therapeutic tool with a growing range of applications in dermatological and cosmetic practice.

PMID: 42279455

Diagnostics (Basel). 2026 May 22;16(11):1587. doi: 10.3390/diagnostics16111587.

ABSTRACT

Background: Vascular adverse events (VAEs) related to facial filler injections are rare but potentially severe complications. Doppler ultrasound has emerged as an adjunct imaging tool for evaluating vascular compromise; however, Doppler findings in facial VAEs remain insufficiently characterized. Objectives: To characterize Doppler ultrasound findings associated with filler-related facial VAEs and to assess whether Doppler patterns differ according to prior hyaluronidase administration. Methods: This international multicenter retrospective observational study included 100 patients with clinically diagnosed facial VAEs following filler injections between May 2022 and April 2025. Doppler ultrasound findings were analyzed, including absent flow in perforators and major arteries, compensatory flow, abnormal waveforms, increased peak systolic velocity (PSV), and absence of Doppler abnormalities. Patients were categorized according to hyaluronidase administration prior to ultrasound evaluation. Descriptive statistics and comparative analyses were performed. Results: One hundred patients (median age, 38 years; IQR: 30-50; 88 women) were evaluated. The most frequent Doppler ultrasound findings were absent flow in perforators (42%) and major arteries (35%), followed by compensatory flow (26%), string sign (18%), flow diversion (16%), and increased peak systolic velocity (16%). No Doppler abnormalities were observed in 12% of cases, while tardus-parvus (9%) and staccato waveform (8%) were less frequent. Doppler ultrasound findings did not differ significantly between patients who received hyaluronidase before imaging and those who did not (all p > 0.05). The dose of hyaluronidase varied substantially. Livedo reticularis, blanching, and pain were the most common clinical findings. Central facial arterial territories, particularly the perioral, nasolabial fold, nasal, and glabellar regions, were most commonly involved. Conclusions: Filler-related facial VAEs show recognizable Doppler ultrasound patterns, and the identification of these patterns may improve localization of vascular occlusion and support ultrasound-guided hyaluronidase administration, potentially enabling more targeted delivery with lower doses.

PMID: 42181154

JPRAS Open. 2026 Jan 30;50:200-207. doi: 10.1016/j.jpra.2026.01.041. eCollection 2026 Jul.

ABSTRACT

BACKGROUND: Hybrid injectable approaches combining calcium hydroxylapatite/carboxymethylcellulose with hyaluronic acid gels may improve both facial contour and skin quality.

METHODS: We retrospectively reviewed 12 women treated with a premixed hybrid filler injected in the subdermal plane across the mid- and lower-face. Outcomes were assessed at baseline and 4 months using the Merz Aesthetic Scales for mid- and lower-face aging severity, the Lemperle Wrinkle Severity Scale (cheek wrinkles), and a 5-point Global Aesthetic Improvement Scale for patient-reported "skin glow."

RESULTS: All Merz domains and cheek wrinkle severity improved at 4 months (cheek wrinkles, p < 0.001). Seven of 12 participants rated their skin glow as "much improved" or "very much improved," and all 12 reported at least "improved." No serious adverse events occurred; bruising resolved spontaneously within 1-2 weeks.

CONCLUSIONS: In this retrospective case series, the premixed hybrid filler was well tolerated and was associated with improvement in mid- and lower-face aging severity and patient-perceived skin glow at 4 months.

LEVEL OF EVIDENCE: IV.