How does Handheld Ultrasound Ensure Trustworthy Results in Aesthetic Medicine?

In 2022, the global aesthetic medicine market was valued at an impressive $75.9 billion, with projections suggesting it could soar to $191.7 billion by 2032 due to increased demand for less invasive treatments^[1^]. Among the forefront innovations is ultrasound technology with real-time imaging for safer and more precise procedures. The rise of handheld ultrasound devices further increases accessibility, serving a vital role at every aesthetic treatment stage from diagnosis to treatment and through post-procedure care, with reduced costs and improved patient satisfaction.

In this blog, explore how handheld ultrasound is transforming aesthetic medicine. In what ways could handheld ultrasound devices streamline workflows for aesthetic practitioners? How can high-intensity focused facial ultrasound enhance the overall safety and effectiveness of aesthetic treatments?

handheld ultrasound application in aesthetic medicine — Handheld Ultrasound Application in Aesthetic Medicine

Advantages of Handheld Ultrasound Devices in Aesthetic Medicine

1.1 Enhanced Precision in Injections

Handheld ultrasound devices enable real-time visualization of the injection site and the needle’s path. This accuracy is crucial for achieving optimal aesthetic results as medications are delivered exactly where needed. Additionally, ultrasound guidance minimizes patient discomfort and increases the success rate of procedures. It not only improves treatment outcomes but also builds client trust and satisfaction.

1.2 Increased Safety and Reduced Liability

The use of handheld ultrasound devices significantly enhances the safety of aesthetic procedures^[2]. By allowing practitioners to avoid critical structures, these devices reduce the risk of complications such as vascular occlusions, which can lead to serious issues like tissue necrosis. This enhanced safety minimizes the potential for medical malpractice claims, thereby lowering the probability of legal liabilities.

1.3 Accessibility and Efficiency

The portable size of handheld ultrasound devices makes them convenient for use in various settings, from clinics to mobile practices. Their ease of use allows practitioners to quickly learn and integrate them into their procedures. The quick setup time means that treatments can be performed more swiftly, reducing patient wait times and increasing the number of procedures that can be done in a day. Additionally, the affordability of these devices, often priced between $350 and $2,500, makes advanced ultrasound technology accessible to a wider range of practitioners, ensuring that high-quality imaging is always available.

neck scanning using Viatom‘s handheld ultrasound device — Neck Scanning using Viatom‘s Handheld Ultrasound Device

Applications of Handheld Ultrasound Devices in Aesthetic Medicine

2.1 For Measurement

2.1.1 Skin Thickness Measurement

Facial skin is a vital beauty indicator, attracting attention from surgeons and dermatologists. As skin aging occurs, the components of the skin undergo varying degrees of degeneration, leading to changes in skin thickness^[3]. As one of the important indicators of facial aging, accurate skin thickness measurement is needed for targeted treatment in aesthetic medicine^[4]. At present, high-frequency ultrasound devices with the characteristics of being noninvasive, rapid, and economical have been gradually applied for laser aesthetics. Such methods correctly assess epidermal, dermal, and subcutaneous layers in normal skin of the forehead, glabella, temple, eyelid, nasal dorsum, zygoma, submandibular, and neck. The gadget provides real-time high-resolution images that are evaluated to estimate skin layer thickness. In practice, it is done three times for precision. The final reading is the average of these readings.

ultrasound image of epidermal and dermal layers — Ultrasound Image of Epidermal and Dermal Layers

Case: Cellulite Measurement for Intradermal Mesotherapy^{^[5]}

A conventional and high-frequency ultrasound investigation on intradermal mesotherapy for cellulite treatment also provided results. Twenty-one ladies first received cellulite-targeted mesotherapy. The handheld ultrasound devices accurately measured epidermis, dermis, hypodermis thickness, echogenicity, and serrated hypodermis-dermis junction surface area. The parameters were collected before and after therapy to monitor changes. A decrease in serrated junction area and hypodermis thickness showed treatment success. The ultrasound precisely showed tissue changes for precise mesotherapy protocol reforms for ultimate outcomes.

Case: Microneedling Depth Assessment

Microneedling is an effective technique that enhances the delivery of various therapeutic agents across the skin barrier by bypassing the stratum corneum and depositing these substances directly into the vascularized dermis^[6]. High-frequency handheld ultrasound devices adopted before microneedle penetration effectively visualize the skin thickness to decide the proper penetration depth and maximize treatment outcomes. This combination of microneedling and ultrasound technology not only optimizes the effectiveness of drug delivery but also enhances overall patient satisfaction by providing more consistent and reliable results.

2.1.2 Vascular Mapping

A thorough understanding of vascular anatomy is essential, as vascular adverse events—such as skin necrosis and, in severe cases, blindness—can occur if filler materials are injected directly into a blood vessel. Ultrasound imaging is a safe and effective tool for the assessment of blood vessels. Doppler ultrasonography allows practitioners to visualize anatomical features using B-mode imaging while simultaneously evaluating both arterial and venous phases in a single examination. This technique enables detailed qualitative analysis of hemodynamics and offers quantitative data through Doppler flow velocity waveforms, which are crucial for optimizing surgical outcomes and minimizing risks. Additionally, recognizing critical structures like the infraorbital and mental foramina, as well as the parotid gland and duct, is vital to prevent nerve or vessel compression and associated functional impairments^[7].

ultrasound image of facial veins on jawline — Ultrasound Image of Facial Veins on Jawline

Case: Nasal Vasculature for Rhinoplasty

Non-surgical filler-based rhinoplasty (NSR) involves the injection of dermal fillers to correct imperfections and augment areas with insufficient tissue in the nose. Although this procedure is rapidly gaining popularity, it presents significant risks due to its potential for serious vascular complications. A study conducted in 2023 investigated the vascular structures of the radix and nasal tip in twenty-one Iranian women using a 14 MHz Doppler portable ultrasound. The findings revealed that 38% of the subjects had superficial midline vessels in the radix, and 86% exhibited at least one vessel in the nasal tip, half of which were classified as deep vessels^[8]. These results underscore the inherent risks associated with traditional NSR, particularly due to the proximity of these vascular structures to the treatment area. Importantly, the use of handheld ultrasound technology can significantly enhance the safety of NSR by allowing for more accurate mapping of nasal vasculature. This advancement can help practitioners avoid vascular adverse events, thereby reducing complications and improving outcomes for patients undergoing NSR.

2.1.3 Previous Filler Scanning

Pretreatment scanning is invaluable for patients with a history of previous filler treatments, as the exact composition of these fillers is often unknown. Ultrasound allows practitioners to identify each deposit with various artifacts demonstrated to tell the type of filler, as well as its location, depth, size, and placement^[9].

When planning for maintenance or enhancement, having a clear understanding of previous filler placements can guide the strategy for new treatments, promoting a more cohesive and visually appealing outcome. This knowledge ensures that the new filler blends seamlessly with existing products and minimizes the risk of overfilling any specific area, which could result in complications like lumps, asymmetry, or an unnatural “pillow face” look^[10].

ultrasound image of previous filler — Ultrasound Image of Previous Filler

2.2 For Cosmetic Enhancement

2.2.1 Visualization of Filler Injection

Cosmetic enhancement through injection therapies, particularly anti-aging treatments, is gaining significant popularity. However, the problem is that once the needle penetrates the skin, the depth and precise location of the needle tip become invisible, and most injectors have a limited understanding of the individual differences in facial layers and how all the different structures relate to each other^[9]. The use of ultrasound effectively enables the injector to visualize the patient’s unique anatomy in real time. This enhanced imaging facilitates greater accuracy in injections by allowing the practitioner to identify both the target layer for filler placement and critical structures that should be avoided.

Case: Hyaluronic Acid Filler

Hyaluronic acid filler injections for tear-trough deformities are an excellent example of a handheld ultrasound application. Ultrasound maps the periorbital anatomy to position the filler correctly. For column-shaped deposits in the orbicularis oculi muscle, the device effectively guides the needle to penetrate just beneath the orbital rim at the correct depth (0.2 mm to 0.5 mm). An ultrasound-guided smooth, uniform fill improves aesthetics and patient safety while preventing intravascular injections.

Case: Botox Injection

People commonly seek facial Botox (Botulinum Toxin) injections to reduce the appearance of wrinkles and fine lines, achieving a more youthful look. Ultrasound guidance in facial Botox injections enhances precision and safety by allowing real-time visualization of facial muscles and tissues. Handheld ultrasound devices are particularly useful for accurately targeting specific muscles, such as those responsible for wrinkles or muscle spasms. While injecting the toxin into the proper muscle layer, the outcomes are more effective, last longer, and limit unwanted effects, with the added benefit of increased comfort during the procedure due to fewer needle insertions.

Case: Lip Filler

Ultrasound guidance in lip filler injections enhances precision and safety by allowing real-time visualization of the lips and surrounding structures. This technique helps practitioners identify tissue planes and the inferior and superior labial arteries, ensuring fillers are placed without compromising blood flow. Using color Doppler, clinicians can avoid vascular occlusions, reducing the risk of complications such as lumps, bruising, and discomfort. Overfilled lips, which can show signs of hypervascularity on ultrasound, can be managed effectively with ultrasound-guided hyaluronidase injections to dissolve excess filler^[11]. More and more expert practitioners agree that handheld ultrasound can predictably scan the lips for precise treatment planning, addressing the current trend of overfilling and ensuring optimal aesthetic outcomes.

real-time ultrasound visualization of lip filling — Real-time Ultrasound Visualization of Lip Filling

2.3 For Evaluation

2.3.1 Evaluation of Surgical Effect^{^[}^¹²^{^]}

Handheld ultrasound excels at the evaluation of breast implant rupture. Breast augmentation is prevalent for cosmetic purposes, but one of its worrisome risks is implant rupture. The rupture of silicone-filled breast implants is usually asymptomatic, but complications due to the migration of free silicone can have life-threatening effects on the body. The American College of Radiology considers magnetic resonance imaging (MRI) the golden standard for breast implant screening when evaluating appropriate breast implant evaluations. However, due to the low prevalence and significant cost of MRI, the U.S. Food and Drug Administration has developed new guidelines recognizing the more widely available and less expensive breast ultrasound as being of equal value to MRI in the assessment of breast implant rupture. In assessing implant integrity, ultrasound has a diagnostic accuracy of 94.7% and can be the preferred test for implant rupture.

The most common area of migration for free silicone is the adjacent breast tissue, and the second most common location is the regional lymph nodes (axillary lymph nodes). Therefore, the diagnosis of breast implant rupture focuses on the ultrasonic scanning of these two areas. It includes:

Implant shell scanning: Uneven implant casing and uneven echo texture within the capsule are signs of rupture.
Axillary lymph node scanning: Axillary lymph nodes containing silicone will show an upper border and lateral sharpness on ultrasound, and the lower border is blurred due to “snowstorm” artifacts.

ultrasound image of breast implant — Ultrasound Image of Breast Implant

Case: Breast Implant Rupture

A radiologist at the Tautrimas Aštrauskas Clinic in Kaunas, Lithuania, performed an ultrasound using a SonoScape S6/S6Pro/S6BW US device in two-dimensional (B2) mode using a 12 MHz linear transducer. The ultrasound scanning revealed signs of implant rupture: shell abnormality and content inhomogeneity.

Through handheld ultrasound devices, doctors can detect any signs of rupture, leaks, or other damage to the implant. This information is crucial for the early detection of potential problems, allowing appropriate medical measures to be taken in a timely manner to avoid complications. In addition, ultrasound helps to assess the health of the surrounding tissues to ensure that there are no infections or other abnormalities.

silicone-filled breast implants — Silicone-filled Breast Implants

2.3.2 Complication Management

Ultrasound devices have revolutionized the management of dermal filler complications by allowing clinicians to see beneath the skin’s surface and identify issues such as nodules, vascular occlusions, and compression in real time. Misplacement of filler, whether in the wrong plane or adjacent to critical structures, can lead to immediate and delayed complications, including product migration and tissue interference. Handheld ultrasound devices facilitate the precise identification and management of these issues, often resolving them in the same session, thus reducing patient interventions and delays. This technology significantly improves outcomes by addressing complications like vascular compromise, infections, and delayed-onset nodules, which can otherwise undermine aesthetic results and cause substantial morbidity.

handheld ultrasound device in complication management — Handheld Ultrasound Device in Complication Management

Case: Thread lifting Complication Management

Thread lifting is a widely used minimally invasive plastic surgery procedure for face lifting. While parotid gland injury is a recognized complication associated with this technique, there is a notable absence of visual evidence documenting this issue. Accurate assessment of the lifting vector and anatomical plane in midface thread lifting is vital to prevent complications, such as damage to the parotid gland. Failure to properly consider these factors can lead to severe issues, including gland perforation, chronic inflammation, and complications like thread protrusion, infection, and dimpling^[13].

Doppler ultrasound can be applied to detect the location of the parotid gland and prevent damage using threads. Furthermore, identifying immediate parotid duct or gland injury with handheld ultrasound devices can help to act quickly for delayed pain or swelling and reduce the likelihood of additional complications.

Case: Hyaluronic Acid Filler Lifetime Accessment

Handheld ultrasound devices are necessary for post-injection examinations. Antonino De Pasquale and colleagues employed high-frequency ultrasound to evaluate hyaluronic acid filler lifetime. It allows for thorough filler monitoring from 7 days post-injection to yearly checkups. Ultrasound scans reliably spotted and recorded the filler, revealing in vivo behavior. It detects whether more treatments are needed and assesses filler effects over time^[14]. If hyaluronic acid fillers have been injected into a blood vessel, an ultrasound-guided hyaluronidase injection can be performed to restore blood flow.

Top Brand of Handheld Ultrasound Devices in Aesthetic Medicine

Viatom

Viatom‘s ultrasound series C10 enhances facial aesthetics with its specialized skin ultrasound probes. These high-frequency probes are designed to assist various aesthetic procedures, including the treatment of acne scars, non-ablative skin resurfacing, and skin lifting and tightening. It’s particularly effective for evaluating the extent and depth of deep skin lesions and swellings.

Multiple clinics across the UK have all recognized the value of Viatom’s high-frequency probes, praising their ability to explore the intricate details of facial muscles, nerves, and other anatomical features in daily practice.

A recent publication in the Journal of Cosmetic Dermatology (October 2023) highlighted the use of mobile ultrasound devices to enhance safety, reduce complications, and ensure better outcomes in non-surgical filler-based rhinoplasty (NSR)^[2]. Similarly, Viatom’s aesthetic ultrasound facilitates the precise administration of various injectables tailored to individual conditions, including popular treatments such as collagen and Botulinum toxin.

viatom c10 series facial ultrasound — Viatom C10 Series Facial Ultrasound

Conclusion

Handheld ultrasound devices are revolutionizing aesthetic medicine by providing unparalleled precision and safety in various procedures. As the aesthetic medicine market continues to expand, projected to reach $205.32 billion by 2033^[15], Viatom is committed to advancing innovations in handheld ultrasound technology. Our focus is on developing even more compact and user-friendly devices, featuring enhanced imaging quality and AI-driven diagnostics, all aimed at meeting patient expectations and streamlining clinical workflows.

References:

[1] Aesthetic Medicine Market Global Industry Analysis, Size, Share, Growth, Trends, Regional Outlook, and Forecast 2023 – 2032. (2024)

https://www.precedenceresearch.com/aesthetic-medicine-market

[2] Ultrasound use in non-surgical, aesthetic medicine clinics (2023)

https://www.thepmfajournal.com/features/features/post/ultrasound-use-in-non-surgical-aesthetic-medicine-clinics

[3] Molecular mechanisms of dermal aging and antiaging approaches. (2019)

https://pmc.ncbi.nlm.nih.gov/articles/PMC6540032

[4] Application of high-frequency ultrasound to assess facial skin thickness in association with gender, age, and BMI in healthy adults (2022)

https://pmc.ncbi.nlm.nih.gov/articles/PMC9205051

[5] Efficacy of intradermal mesotherapy in cellulite reduction – Conventional and high-frequency ultrasound monitoring results. (2024)

https://www.tandfonline.com/doi/full/10.1080/14764172.2017.1334927

[6] Microneedling – National Library of Medicine (2022)