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. 2025 Jan;24(1):e16759.
doi: 10.1111/jocd.16759.

Recommendations on Ultrasound-Guided Hyaluronic Acid Soft Tissue Augmentation of the Upper Face in Asians

Jae Yoon Jung  1 , Hosung Choi  2 , Sang Chul Han  3 , Rungsima Wanitphakdeedecha  4 , Qian Luo  5 , Lijun Zhou  6 , Jung Im No  7 , Woonji E Jang  7 , Hee-Jin Kim  8
Affiliations

Recommendations on Ultrasound-Guided Hyaluronic Acid Soft Tissue Augmentation of the Upper Face in Asians

Jae Yoon Jung et al. J Cosmet Dermatol. 2025 Jan.

Abstract

Background: Ultrasonography allows real-time imaging of facial soft tissue during hyaluronic acid (HA) filler injections. However, there is currently limited guidance relating to ultrasound-guided HA filler placement in the upper face.

Aims: To develop guidance for the effective use of ultrasonography to improve the safety of HA filler injection procedures.

Methods: Through a series of online video conferences and anatomical studies conducted on a model and a cadaveric specimen, specialists from Korea, Thailand, and China drew recommendations for ultrasound-guided filler injections of the upper face.

Results: The authors outlined critical anatomical landmarks for safe HA filler placement to correct volume deficits or treat hollowness of the forehead, temple, and upper eyelids. They provide insights on treatment indications and injection techniques using ultrasound for safe HA filler placement. The recommendations are presented in this paper.

Conclusions: Where there are anatomic variations in the vasculature of the forehead, temple, and periorbital area, ultrasound-guided filler placement can provide an additional safety measure. Current evidence may give rise to standard practices incorporating ultrasound in injection protocols for the preventive and therapeutic management of adverse events.

Keywords: forehead; hyaluronic acid filler; injection; temple; ultrasonography; upper eyelid.

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Conflict of interest statement

Beyond this study, J.Y.J., H.C., S.C.H., R.W., Q.L., L.Z., and H‐.J.K. declare no conflicts of interest. J.I.N. and W.E.J. are full‐time employees of LG Chem Co. Ltd.

Figures

FIGURE 1
FIGURE 1
Injection technique for forehead filler treatment (entry points are represented by red dots).
FIGURE 2
FIGURE 2
A demonstration of the midpoint approach for the forehead (41‐year‐old Korean female). (A) Clinical injection. (B) Clinical ultrasound. (C) Cadaver dissection (72‐year‐old Korean male). (D) A photo of the lateral approach for the forehead.
FIGURE 3
FIGURE 3
Injection technique for temple filler treatment. Superficial plane: Between superficial temporal fascia and deep temporal fascia.
FIGURE 4
FIGURE 4
A demonstration of the superficial plane injection technique in the temple (41‐year‐old Korean female). (A) Clinical injection. (B) Clinical ultrasound. (C) Cadaver dissection (72‐year‐old Korean male).
FIGURE 5
FIGURE 5
A demonstration of filler placement following the deep plane injection. technique in the temple (72‐year‐old Korean male). (A) Cadaver dissection. (B) Cadaver ultrasound.
FIGURE 6
FIGURE 6
Injection technique for filler treatment of sunken eyes.
FIGURE 7
FIGURE 7
A demonstration of superficial plane injection of filler in the upper eyelid (41‐year‐old Korean female). (A) Clinical injection. (B) Clinical ultrasound. (C) Cadaver dissection (72‐year‐old Korean male).
FIGURE 8
FIGURE 8
A demonstration of deep‐plane injection of filler in the upper eyelid (41‐year‐old Korean female). (A) Clinical injection. (B) Clinical ultrasound (C) Cadaver dissection (72‐year‐old Korean male).
See this image and copyright information in PMC

References

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