The following is a summary of “Investigating the Anatomic Location of Soft Tissue Fillers in Noninflammatory Nodule Formation: An Ultrasound-Imaging–Based Analysis,” published in the June 2023 issue of the Dermatologic Surgery by Schelke et al.
Noninflammatory nodules may be resistant to dissolution. A case series of ultrasound images and medical data of patients referred prospectively with noninflammatory nodules were evaluated to determine the potential causes. There were 27 patients with nodules but no indicators of inflammation. All cases were evaluated using a linear 18-MHz ultrasound device. The precise location of the infill was noted.
Using chi-square analyses, the relationships with clinical data were examined. There were 16 patients with an early commencement of complaints (<2 weeks) and 11 with a late onset (>2 weeks). All patients had multiple nodules. In every instance, the infill nodule was located within the fascia. There was an extension to the subcutaneous tissue in eight cases and in five cases to the deeper planes. In 14 cases, the infill material was completely positioned within fascia layers, while migration was observed in 5 instances.
Accumulation of filler material in the superficial musculoaponeurotic system or fascia may play a significant role in the development of persistent noninflammatory nodules, either as a result of an initial injection error or subsequent accumulation via the pathway created by a needle or cannula. Injections guided by ultrasound help dissolve the nodule.
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