| Echogenicity Type | Ultrasound Appearance | Common Structures / Materials | Aesthetic Relevance |
|---|---|---|---|
| Hyperechoic | Bright echogenic structures with strong reflection, sometimes with posterior acoustic shadowing | Bone cortex, periosteum, fascia, ligaments, fibrosis, CaHA fillers | Identification of tissue planes, bone surface, and calcium-based fillers |
| Echogenic | Bright gray linear or band-like structures | SMAS, superficial fascia, fibrous septa | Tissue layer recognition and injection planning |
| Isoechoic | Similar echogenicity compared with surrounding tissues | Some soft tissues and muscle structures | Normal anatomical recognition |
| Hypoechoic | Dark gray structures with relatively weak echoes | Muscle, fat tissue, some HA fillers | Fat analysis, muscle localization, filler identification |
| Anechoic | Black areas without internal echoes | Blood vessels, fluid collections, some HA fillers | Vessel identification and fluid assessment |
| Mixed Echogenicity | Heterogeneous combination of hyperechoic and hypoechoic areas | Inflammation, granuloma, complex filler reactions | Evaluation of abnormal findings and follow-up |
| Anatomical Structure | Ultrasound Appearance | Imaging Characteristics | Aesthetic Relevance |
|---|---|---|---|
| Epidermis | Superficial continuous hyperechoic line | Strong reflection from keratin layer | Skin layer identification |
| Dermis | Slightly echogenic layer beneath epidermis | Rich collagen structure | Skin thickness assessment |
| Subcutaneous Fat | Hypoechoic fat lobules with echogenic septa | Honeycomb-like structure | Volume analysis and injection planning |
| Deep Fat Compartments | Relatively homogeneous hypoechoic structures | Regional thickness variation | Facial rejuvenation planning |
| SMAS Fascia | Continuous hyperechoic band | Clear anatomical boundary | Injection layer planning and lifting procedures |
| Ligaments | Strong hyperechoic linear structures | Maintain facial structural support | Identification of high-risk areas |
| Muscle | Hypoechoic to isoechoic with parallel echogenic fibers | Dynamic changes with movement | Botulinum toxin treatment guidance |
| Bone Surface | Bright hyperechoic line with posterior shadowing | Reflection from cortical bone | Deep structural localization |
| Cartilage | Hypoechoic band-like structure | Usually limited vascular signals | Nasal and auricular assessment |
| Vessel | Round or tubular anechoic structure | Blood flow detected by Doppler | Vessel mapping and injection safety |
| Gland | Intermediate to hyperechoic structure | Different appearance from surrounding tissues | Gland evaluation |
| Filler Material | Typical Ultrasound Appearance | Imaging Characteristics | Aesthetic Application |
|---|---|---|---|
| Hyaluronic Acid (HA) | Hypoechoic or anechoic | Pseudocystic appearance with relatively clear margins | Filler localization and volume assessment |
| Calcium Hydroxylapatite (CaHA) | Strong hyperechoic signal | Often associated with posterior acoustic shadowing | Identification of calcium-based fillers |
| Poly-L-lactic Acid (PLLA) | Small hyperechoic dots | Scattered echogenic particles | Evaluation of biostimulatory fillers |
| Polycaprolactone (PCL) | Variable appearance | Depends on material characteristics and tissue response | Filler follow-up evaluation |
| Fat Grafting | Hypoechoic or mixed echogenicity | Influenced by graft survival and fibrosis | Fat graft assessment |
| Polyacrylamide Hydrogel (PAAG) | Anechoic or mixed echogenicity | May present as fluid-like structures | Foreign material evaluation |
| Silicone / Other Foreign Materials | Strong hyperechoic reflection | Prominent acoustic shadowing | Foreign material identification |
The appearances above are typical ultrasound findings; actual images may be affected by material type, injection time and tissue reaction.
| Finding | Ultrasound Appearance | Clinical Relevance |
|---|---|---|
| Overfilling | Increased tissue thickness and altered tissue planes | Assessment of excessive volume |
| Filler Migration | Filler located outside the expected anatomical plane | Support treatment planning |
| Nodules | Localized hypoechoic or mixed echogenic lesions | Evaluation of post-injection tissue response |
| Granuloma | Irregular mixed echogenic lesions | Assessment of delayed tissue reaction |
| Inflammatory Response | Tissue thickening with increased Doppler signals | Evaluation of inflammatory activity |
| Infection / Abscess | Fluid collection with increased surrounding vascularity | Infection assessment |
| Vascular Abnormalities | Abnormal Doppler findings requiring clinical correlation | Injection risk assessment |
Note: ultrasound findings should be interpreted in combination with clinical symptoms, treatment history and other examinations.