THURSDAY, Dec. 4, 2025 (HealthDay News) -- Ultrasound can provide relevant information to support the diagnosis of vascular adverse events (VAEs) associated with use of cosmetic fillers, including hyaluronic acid (HA), according to a study presented at the annual meeting of the Radiological Society of North America, held from Nov. 30 to Dec. 4 in Chicago.

Rosa Maria Silveira Sigrist, M.D., from the University of São Paulo in Brazil, and colleagues conducted a retrospective, international study across four radiology centers, one dermatology center, and one plastic surgery center between May 2022 and April 2025 to identify the most frequent Doppler ultrasound findings in filler-induced VAEs. High-frequency color or power Doppler ultrasound were used to assess patients presenting with clinical signs of facial VAEs following filler injections.

Overall, 93 percent of the 100 patients were female, 98 percent had received HA fillers, and 79 percent received hyaluronidase prior to Doppler evaluation. The researchers found that the most common color Doppler findings were absent flow in perforator vessels, absent flow in major vessels, compensatory flow, string sign, and increased peak systolic velocity (42, 35, 26, 18, and 16 percent, respectively). There was no significant association between hyaluronidase use and specific Doppler findings. There was a moderate correlation between absent flow in perforators and compensatory flow, while a significant association was seen for lateral nasal artery involvement with absent major vessel flow.

"If we can see the ultrasound finding, we can target the exact place where the occlusion occurs," Sigrist said in a statement. "Rather than flooding the area with hyaluronidase, we can do guided injections that use less hyaluronidase and provide better treatment results."

Press Release

More Information