Frontotemporal filling guided by computed tomography angiography and high-frequency ultrasound: A prospective clinical study
Background: Frontotemporal filling injections have become key components in facial rejuvenation treatment. The application of computed tomography angiography and ultrasound-guided technology for frontotemporal filling injections provides new possibilities for improving injection safety and accuracy.
Aim: This study aimed to evaluate a frontotemporal filling approach guided by computed tomography angiography and high-frequency ultrasonography.
Methods: A prospective, single-center study was conducted in 20 female Asian patients seeking cosmetic treatment. Computed tomography angiography was performed for pretreatment evaluation. Various quantitative anatomical measurements of the superficial temporal artery were performed. Subsequently, the plastic surgeon administered the injections under real-time ultrasound guidance.
Results: Clinical evaluation scores were recorded at baseline and 1, 3, and 6 months after the final treatment session. No severe adverse events were observed. Mild or moderate transient adverse events included pain, swelling, erythema, bruising/hematoma, and one palpable nodule. The Global Aesthetic Improvement Scale scores improved from 3.0 ± 0.0 at baseline to 4.3 ± 0.5, 4.6 ± 0.4, and 4.5 ± 0.5 at 1, 3, and 6 months, respectively.
Conclusion: The application of computed tomography angiography and ultrasound-guided technology may provide patients with more comprehensive and personalized aesthetic improvements.
- de Maio M, Swift A, Signorini M, Fagien S. Facial Assessment and Injection Guide for Botulinum Toxin and Injectable Hyaluronic Acid Fillers: Focus on the Upper Face. Plast Reconstr Surg. 2017;140(2):265e-276e. doi: 10.1097/PRS.0000000000003544
- Costanzo D, Romeo A, Marena F. Autologous Fat Grafting in Plastic and Reconstructive Surgery: An Historical Perspective. Eplasty. 2022;22:e4.
- Trevidic P, Kim HJ, Harb A, Ho WWS, Liew S. Consensus Recommendations on the Use of Hyaluronic Acid-Based Fillers for Nonsurgical Nasal Augmentation in Asian Patients. Plast Reconstr Surg. 2022;149(2):384-394. doi: 10.1097/PRS.0000000000008722
- Wang D, Xiong S, Zeng N, et al. Facial Arterial Variations in Asians: A Study on Computed Tomographic Angiography. Aesthet Surg J. 2021;42(5):527-534. doi: 10.1093/asj/sjab380
- Machado RA, Oliveira LQ, Martelli-Júnior H, et al. Adverse reactions to the injection of face and neck aesthetic filling materials: a systematic review. Med Oral Patol Oral Cir Bucal. 2023;28(3):e278-e284. doi: 10.4317/medoral.25713
- Zhuang J, Zheng Q, Su X, Jiang L, Hu J. Clinical Manifestations and Prognosis of Embolism Caused by Filler Injection in Different Facial Regions. Plast Reconstr Surg Glob Open. 2023;11(8):e5225. doi: 10.1097/GOX.0000000000005225
- Bravo BSF, Carvalho RM, Elias MC, et al. Nasal filling guided by high frequency ultrasound: Reducing risks. J Cosmet Dermatol. 2024;23(10):3256-3262. doi: 10.1111/jocd.16430
- Yuan L, Zhuang J, Zheng Q, et al. Application of High- Frequency Ultrasound to Evaluate Forehead Filling Materials. Aesthetic Plast Surg. 2024;48(12):2239-2245. doi: 10.1007/s00266-024-04031-z
- Dissaux B, Robert A, Duigou M, Lefèvre C, Ognard J, Seizeur R. Radiological anatomical measurements of the superficial temporal artery: an interobserver reproducibility study. Surg Radiol Anat. 2024;47(1):27. doi: 10.1007/s00276-024-03520-9
- Bueller H. Ideal Facial Relationships and Goals. Facial Plast Surg. 2018;34(5):458-465. doi: 10.1055/s-0038-1669401
- Alfertshofer M, Engerer N, Frank K, Moellhoff N, Freytag DL, Cotofana S. Multimodal Analyses of the Aging Forehead and Their Clinical Implications. Aesthet Surg J. 2023;43(7):NP531-NP540. doi: 10.1093/asj/sjad009
- Kim SB, Hu H, Bae H, Yi KH. Anatomy of the temporal region to guide filler injections. Surg Radiol Anat. 2024;46(5):615- 624. doi: 10.1007/s00276-024-03340-x
- Lim T. Facial Overfilled Syndrome. Dermatol Clin. 2024;42(1):121-128. doi: 10.1016/j.det.2023.06.007
- Beleznay K, Carruthers JD, Humphrey S, Jones D. Avoiding and Treating Blindness From Fillers: A Review of the World Literature. Dermatol Surg. 2015;41(10):1097-1117. doi: 10.1097/dss.0000000000000486
- Zhao F, Chen Y, He D, You X, Xu Y. Disastrous cerebral and ocular vascular complications after cosmetic facial filler injections: a retrospective case series study. Sci Rep. 2024;14(1):3495. doi: 10.1038/s41598-024-54202-w
- Koziej M, Trybus M, Hołda M, et al. The Superficial Temporal Artery: Anatomical Map for Facial Reconstruction and Aesthetic Procedures. Aesthet Surg J. 2019;39(8):815-823. doi: 10.1093/asj/sjy287
- Swift A, Green JB, Hernandez CA, et al. Tips and Tricks for Facial Toxin Injections with Illustrated Anatomy. Plast Reconstr Surg. 2022;149(2):303e-312e. doi: 10.1097/PRS.0000000000008708
- Kroumpouzos G, Harris S, Bhargava S, Wortsman X. Complications of fillers in the lips and perioral area: Prevention, assessment, and management focusing on ultrasound guidance. J Plast Reconstr Aesthet Surg. 2023;84:656-669. doi: 10.1016/j.bjps.2023.01.048
- Sahinarslan A, Erbas G, Kocaman SA, et al. Comparison of radiation-induced damage between CT angiography and conventional coronary angiography. Acta Cardiol. 2013;68(3):291-297. doi: 10.1080/ac.68.3.2983424
- Zhong X, Zhao L. Hypersensitivity reactions to iodinated contrast media: potential mechanisms and clinical management. Front Med (Lausanne). 2025;12. doi: 10.3389/fmed.2025.1582072
- Winther S, Svensson M, Jørgensen HS, et al. Repeated Contrast Administration Is Associated With Low Risk of Postcontrast Acute Kidney Injury and Long-Term Complications in Patients With Severe Chronic Kidney Disease. Am J Transplant. 2016;16(3):897-907. doi: 10.1111/ajt.13545