OnabotulinumtoxinA and Hyaluronic Acid in Facial Wrinkles and Folds: A Prospective, Open-Label Comparison

High-Frequency Ultrasound of Facial Filler Materials in the Nasolabial Groove

BACKGROUND

Various dermal fillers are often used for nasolabial groove filling. High-frequency ultrasonography might be a valuable tool for assessing facial filler materials.

METHODS

The facial ultrasound images of plastic surgery hospital of the Chinese Academy of Medical Sciences from November 2014 to November 2021 were analyzed and judged.

RESULTS

A total of 94 patients who underwent high-frequency ultrasound with a nasolabial groove filler were included in the study. Hyaluronic acid was detected in 35 cases, polyacrylamide in 34 cases, lipofilling in 10 cases, silicon oil in seven cases, calcium hydroxyapatite in six cases, and silicone implant in two cases. The ultrasonic performance of hyaluronic acid was divided into four types: aggregation, diffusion, mixed pattern, and associated infection; of polyacrylamide was divided into five types: aggregation and inclusion, aggregation and non-inclusion, diffusion, mixed pattern, and associated infection; and of lipofilling was divided into four types: aggregation, diffusion, fat liquefaction necrosis, and cystic change. Echo intensity, echo characteristics, boundary clarity, fluidity, and blood flow signals can be used as the basis for identifying filler materials.

CONCLUSION

High-frequency ultrasound has an identification significance for the filling materials in the area of nasolabial groove.

LEVEL OF EVIDENCE IV

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Are We Measuring What Really Counts?

Most published clinical research is faulty because of many reasons, one being faulty design. A remedy to this problem is the correct utilization of the PICOT (population, intervention, comparative intervention, outcome and time horizon) format in the design of a clinical research question. One element of the PICOT format, "outcome," has not been assessed adequately in aesthetic surgery. In this review, we found that in the last decade of all randomized controlled trials and comparative studies published in Aesthetic Surgery Journal, only about half specified a primary outcome. Regrettably, only 40% reported both a primary outcome and justification for choosing this outcome. This poses a credibility issue with the conclusions of the majority of published studies. There is an urgent need to develop critical outcome sets for aesthetic procedures to be utilized by future investigators. With such a critical outcome set, we will be able to pool the results of multiple studies on the same subject and reach conclusive results.