Resumen

Objectives: Characterization of Periorbital Filler Complications with High-Frequency Ultrasound: A Practical Diagnostic Approach Introduction: Periorbital filler complications are diagnostically challenging due to complex anatomy and overlapping clinical presentations. High-frequency dermatologic ultrasound (US) allows real-time, non-invasive assessment of filler type, depth, and associated tissue changes, supporting safer, image-guided clinical decision-making in aesthetic dermatology. Results: Distinct, reproducible, product-specific ultrasound patterns were identified: hyaluronic acid deposits in the dermis or subcutis producing the Tyndall effect; residual hyaluronic acid with surrounding fat hyperechogenicity consistent with late-onset inflammatory edema (ETIP); calcium hydroxyapatite nodules appearing as linear hyperechoic deposits with posterior acoustic shadowing near retaining ligaments; and polycaprolactone matrix characterized by hypoechoic areas with bright foci and comet-tail artifacts. No abnormal vascularization was observed. Conclusion: High-frequency dermatologic ultrasound provides a reliable, non-invasive method to characterize periorbital filler complications and offers clinicians a practical, ultrasound-based diagnostic framework to guide management and enhance patient safety in aesthetic practice.