After injection of 28 vials of Hylenex failed to reverse a vascular occlusion that occurred following a filler injection to the lips and chin, it was time to call Dr. Stella Desyatnikova, MD.
A double board certified facial plastic surgeon, Dr. Stella is known to use ultrasound at her practice to look for vessels before filler injections, improving both patient safety and confidence.
“I have been using ultrasound for a while, but have never reversed a vascular occlusion before I was asked to help with this case,” says Dr. Stella. “I messaged Dr. Leonie Schelke in Amsterdam who is a world authority on the subject for pointers. She is an incredible human being and stayed online with us, watching the screen while we looked for the blockage.”
Dr. Stella Shared Her Experience Reversing a Vascular Occlusion Using Ultrasound Guidance – the First Case Reported in the United States!
“We found the area with the abnormal blood flow in the chin. A small lump of filler seemed to be putting pressure on the arteries.“
“We injected the lump of filler with only half a vial of hyaluronidase under ultrasound guidance. Immediately, skin appearance and capillary refill were improved and blood flow on ultrasound dramatically improved as well,” Dr. Stella explains. “The patient’s facial skin looked good the next day and she is now completely back to normal.”
This Video Shows Normal Blood Flow During the Patient’s Ultrasound Exam the Next Day
Dr. Stella credits the power of human collaboration and modern technology for the successful case. “Three women worked together across the continents to rescue our beautiful patient’s face. As far as I know, this is the first case of its kind in the United States!”
Prior to acquiring the Clarius L20 HD in 2020, Dr. Stella hadn’t used ultrasound since her time in residency. She is mostly self-taught through online learning, reading books, and hands-on practice.
“If you haven’t used ultrasound, it’s quite a steep learning curve – it’s not enough to buy the device and get to where you need to go. It takes a lot of training and practice to understand what you’re doing, but it’s worth the effort,” says Dr. Stella. “I do a lot of advanced injections such as nose injections, which is the highest risk area for blindness. It’s a very small risk, but using ultrasound to look for abnormal vessels before we inject gives us peace of mind.”
Vessel depth and location matters. Dr. Stella has focused her training on learning how to identify vessels quickly to be able to inject safely around the larger facial arteries – dorsal nasal, supratrochlear, supraorbital, angular, temporal – to prevent necrosis and blindness.
Learn More About Ultrasound in Facial Aesthetics
If Dr. Stella’s experience with using ultrasound to improve dermal filler outcomes has piqued your interest, we invite you to watch our free on-demand webinar on using ultrasound for vascular mapping, evaluating fillers, and treating complications. In this 1-hour webinar, renowned ultrasound expert Dr. Steven Weiner teaches how to clearly visualize facial vascular networks in minutes to eliminate risk and keep patients safe.
Or visit Clarius Classroom for a series of instructional videos on using Clarius for facial aesthetics and plastic surgery.
The miniaturization of high-definition ultrasound and advances in artificial intelligence has made it easy and affordable to add Clarius HD to your aesthetics practice. Dr. Weiner and Dr. Stella are using the Clarius L20 HD: ideal for facial aesthetics, it’s the world’s first ultra-high-frequency handheld ultrasound scanner designed for superficial scanning. Contact us today or request an ultrasound demo to see the difference ultra-high-definition imaging makes in facial vascular mapping.