The development of high-frequency devices and transducers in recent years has enabled the growth of the use of dermatological ultrasound (US). Real-time monitoring of the anatomy of the face during the application of aesthetic injectables potentially prevents complications such as vascular occlusions. The injecting physicians who are starting out in the practice of ultrasound-guided injections are commonly faced with practical questions about its use. In this approach based on experience with US-guided filler injections of 2 large clinical centers in two countries, the authors summarize the steps to start the use of ultrasound to guide injectable aesthetic procedures, such as fillers and biostimulators. First, the authors discuss factors that guide the choice of an equipment and of ultrasound transducers to perform the procedures. Next, the authors have a detailed discussion on practical issues related to the procedure. Then, the authors will approach forms of positioning the professionals and equipment in the treatment field. The authors conclude with the suggestion of two possible techniques to guide injectable procedures: 1) scan before injecting or 2) scan while injecting.
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