This Is What Filler Looks Like On Ultrasound

Hi everyone, I'm Dr. Jane Yoo, board-certified dermatologist and Mohs surgeon. That dark pocket you're looking at on this ultrasound is hyaluronic acid filler beneath the skin. In some patients, we can still see filler years after it was originally injected, even when they were told it should already be gone. Hyaluronic acid often shows up dark or anechoic to hypoechoic on ultrasound. Radiesse looks completely different. Calcium hydroxyapatite is typically much brighter and can cast an acoustic shadow. Silicone can produce a characteristic snowstorm pattern. These patterns aren't always perfectly definitive, but in many cases ultrasound can help me determine whether filler is actually present, what type of product I may be looking at, how deep it is, and exactly where it's sitting. And that matters because hyaluronidase only dissolves hyaluronic acid. Instead of finding out after multiple failed dissolving sessions, I want to know what I'm actually treating before I inject anything. You can't reliably determine all of that just by looking at someone's face or feeling it from the outside.