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

Summary

Multinational experts synthesized ultrasound-based recommendations for safe HA filler injections in the Asian upper face, detailing vascular landmarks and technique adaptations for the forehead, temple, and upper eyelid. The guidance positions ultrasound as an adjunct to prevent and manage vascular adverse events.

Key Findings

• Defines ultrasound landmarks and safe planes for HA filler in forehead, temple, and upper eyelid.
• Recommends ultrasound as an adjunct to mitigate vascular variability and reduce ischemic events.
• Provides indication-specific technique tips tailored to Asian facial anatomy.

Clinical Implications

Adopt pre-injection ultrasound mapping and real-time guidance in the forehead, temple, and periorbital regions to reduce vascular injury; incorporate ultrasound into protocols for early detection and management of filler-related adverse events.

Limitations

• Consensus-based guidance without prospective clinical outcome validation.
• Focused on Asian anatomy; generalizability to other populations may be limited.

Future Directions

Prospective studies comparing ultrasound-guided versus landmark-only injections on vascular event rates; development of ultrasound training curricula and competency benchmarks.