摘要

Objectives: Hopefully after attending this session, participants will be able to : 1. Understand that not every chubby cheeks is equal. Not every chubby cheek should be treated by toxin or fat lipolysis. 2. Apply ultrasound to deeply recognize different structure that contribute to chubby cheek 3. Integrate ultrasound into daily aesthetic practice to improve patient safety through precise injection Introduction: Lower facial fullness is one of the most common aesthetic complaints, often recognized as “chubby cheeks.” However, similar external morphology may arise from different anatomical structures, including subcutaneous adipose hypertrophy, masseter muscle enlargement, or parotid gland hypertrophy. Masseter muscle hypertrophy is the easiest to examine since palpation can acurately lead us to the diagnosis. However, adipose hypertrophy and parotid gland hypertrophy is more challenging to diagnose without imaging. Materials / method: Patients presenting with "chubby cheek" were evaluated using clinical examination and high-frequency ultrasound imaging. Ultrasound was used to assess and map the anatomical structure that are subcutaneous fat thickness, masseter muscle size, and parotid gland extension. Based on ultrasound findings combined with clinical presentation, individualized treatment is planned and adjusted accordingly. This approach enhances treatment predictability. Results: Ultrasound imaging allowed clear differentiation between adipose hypertrophy, masseter muscle enlargement, and parotid gland hypertrophy. Moreover, ultrasound imaging can also give us data regarding subcutaneous fat depth and thickness, masseter muscle depth with its Deep Inferior Tendon (DIT) pattern, parotid gland depth and its extension. Ultrasound ensure what doctor evaluate outside compare to what doctor see inside Conclusion: Using High Frequency Ultrasound is a valuable diagnostic tool for evaluating lower facial fullness (Chubby Cheek). It enables real time anatomical assessment, improves treatment precision, and help create personalized treatment. Using Ultrasound into daily aesthetic practice will surely enhance patient safety and minimize misdiagnosis which in turn enhance patient satisfaction.