American Association of Plastic Surgeons

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High-resolution Ultrasound Mapping Of The Facial Artery At The Mandible And Nasolabial Fold To Prevent Filler-related Complications
Pragna N. Shetty, MD, MPH1, Nina Mehta, BS2, Joshua B. Romero, BA2, Kamran Khan, MD1, Lynn Damitz, MD1;
1UNC Division of Plastic & Reconstructive Surgery, Chapel Hill, NC, USA, 2UNC School of Medicine, Chapel Hill, NC, USA

PURPOSE: According to recent reports from the International Society of Aesthetic Plastic Surgery, dermal fillers rank as the second most prevalent non-surgical aesthetic procedure, constituting 30% of such treatments. Although ischemic complications from facial fillers are infrequent, consequences can be severe, potentially resulting in vision impairment, stroke, or tissue necrosis. As "jaw-line" fillers gain popularity, it becomes imperative for practitioners to possess an in-depth knowledge of facial anatomy, particularly critical vasculature like the facial artery. Integration of handheld ultrasound devices offers enhanced precision, potentially mitigating risks and reducing complications during procedures.
METHODS: We recruited 10 subjects to undergo ultrasound guided facial mapping at the mandible and nasolabial fold using the Clarius (HD, 8-20 MHz) L20 handheld high-frequency ultrasound. Volunteers were recruited from August 1 to September 1, 2023. Demographics for each subject included in the study were tracked.
RESULTS: Five volunteers were male and five were female. The average age was 28.5 years. The average depth to the facial artery at the nasolabial fold was 3.4±0.6 mm and the distance from the angle of the mandible to facial artery was 4.8±0.9mm.
CONCLUSION: High-resolution ultrasound can be utilized to map the location of the facial artery prior to “jaw-line” or nasolabial fold filler injection. Depth and distance from angle of the mandible can be used to predict the location of the facial artery rather than relying on traditional safety measures. We continue to gather data to increase our study’s sample size with the inclusion of all facial vasculature.
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