BACKGROUND The popularity of dermal fillers in aesthetic procedures has led to an increase in complications, including nodules that can be challenging to diagnose and treat. The role of ultrasound as a noninvasive diagnostic tool across different fillers remains underexplored. OBJECTIVE To investigate the clinical features and ultrasound characteristics of dermal filler nodules. MATERIALS AND METHODS The authors conducted a retrospective cohort study from February 2018 to December 2024, enrolling 62 patients with filler nodules referred to a tertiary center. Demographic data, filler types, clinical history, and cultures were collected and analyzed. Nodules were evaluated by ultrasound for their echogenicity, border definition, and internal architecture. RESULTS Most patients were women (88.7%), with a mean age of 44.9 years. Hyaluronic acid was the most commonly reported filler, followed by polycaprolactone and poly- d , l -lactic acid. The midface was the most frequent site of nodule development. Ultrasound imaging revealed distinct, filler-specific characteristics: hyaluronic acid nodules evolved from anechoic “jelly” to hypoechoic “stormcloud” patterns; poly- d , l -lactic acid nodules presented as well-circumscribed hyperechoic “snow globe” formations; polycaprolactone ranged from fibrotic “dragon-beard candy” to layered “water ripple” patterns; and silicone resembled diffuse, ill-defined “snowstorm” echotexture. CONCLUSION Ultrasound reveals filler nodule patterns, supporting more accurate diagnosis and safer, individualized treatment.
Chiang et al. (Fri,) studied this question.