Clinical application of visualized ultrasound in complications of facial injection

Objetivos: 1.The importance of visualized ultrasound in facial injection complications. 2.Methods of using visualized ultrasound in facial injection complications. 3.Case sharing of visualized ultrasound‑assisted management of facial injection complications, including: vascular embolism, Facial Overfilled Syndrome (FOS), delayed hypersensitivity reaction, etc Introducción: Aesthetic trends have shifted from "augmentation" to "subtraction," with more precise injections at shallower layers. However, complications have become more insidious (atypical embolism, Facial Overfilled Syndrome [FOS], delayed nodules). Traditional empirical "blind injection" makes it difficult to locate, characterize, or verify the problem. Visualized ultrasound, capable of identifying fillers, vessels, and inflammatory changes, has become a key tool in managing complications. Materiales / método: High-frequency linear array ultrasound combined with color Doppler was used. A three‑step protocol was implemented: ① Pre‑operative diagnosis – determining filler depth, vascular compression, and nodule characteristics (presence or absence of blood flow); ② Intra‑operative guidance – real‑time needle tip monitoring and layered injection of hyaluronidase or corticosteroids; ③ Post‑operative assessment – evaluating drug dispersion, blood flow recovery, and absorption. Resultados: ① Vascular embolism: Ultrasound located an embolized branch of the infraorbital artery; after ultrasound‑guided dissolution around the facial artery, blood flow recovered and skin turned pink within 24 hours. ② FOS: A hypoechoic nodule without blood flow; layered hyaluronidase injection under ultrasound guidance led to nodule absorption and smooth skin at 2 weeks. ③ Delayed hypersensitivity/infection: Ultrasound revealed deep residual HA; targeted dissolution restored natural contour. The entire process enabled precise, safe, and verifiable treatment, avoiding blind operations. Conclusión: Visualized ultrasound runs through the entire diagnosis and treatment course of complications, changing "blind injection" into "visualized injection" and significantly improving localization accuracy and treatment safety. It serves as the doctor's "second eye" for managing insidious complications and is a technical cornerstone for future precise injection and subtraction aesthetics.