Laser Speckle Contrast Imaging Guides Needling Treatment of Vascular Complications from Dermal Fillers

Aesthetic Plast Surg. 2024 Mar;48(6):1067-1075. doi: 10.1007/s00266-023-03629-z. Epub 2023 Oct 10.

Abstract

Background: Although laser Doppler imaging (LDI) accurately delineates a hypoperfused area to help target hyaluronidase treatment, laser speckle contrast imaging (LSCI) is more appropriate for assessing microvascular hemodynamics and has greater reproducibility than LDI. This study investigated the use of LSCI in the evaluation and treatment of six patients who developed vascular complications after facial dermal filler injections.

Methods: The areas of vascular occlusion were accurately defined in real time by LSCI and were more precise than visual inspections or photographic evidence for guiding needling and hyaluronidase treatment.

Results: All patients had achieved satisfactory outcomes as early as Day 2 of treatment and no procedure-related complications were reported after a median follow-up of 9.5 (7-37) days.

Conclusion: LSCI accurately and noninvasively delineated vascular occlusions in real time among patients experiencing complications of facial dermal filler injections. Moreover, LSCI was more accurate than visual and photographic evaluations. Clinicians can use LSCI to reliably follow-up therapeutic outcomes after salvage interventions for vascular occlusions.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Dermal fillers; Hypoperfusion; Laser speckle contrast imaging; Needling; Vascular complications.

MeSH terms

  • Cosmetic Techniques* / adverse effects
  • Dermal Fillers* / adverse effects
  • Humans
  • Hyaluronic Acid
  • Hyaluronoglucosaminidase
  • Laser Speckle Contrast Imaging
  • Percutaneous Collagen Induction
  • Reproducibility of Results

Substances

  • Dermal Fillers
  • Hyaluronoglucosaminidase
  • Hyaluronic Acid