{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T09:39:59Z","timestamp":1792143599368,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T00:00:00Z","timestamp":1743811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To provide insight into the characteristics, layer locations, and corporal distribution of the granulomatous reactions to cosmetic fillers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An international retrospective multicentric study was performed in centers that scan complications of cosmetic fillers. Inclusion criteria were patients with previous injections of known cosmetic fillers confirmed by ultrasound and ultrasonographic features of granulomatous reactions such as hypoechoic nodules, pseudonodules, or hypoechoic tissue surrounding the deposit regions. The ultrasound studies followed the published guidelines for performing dermatologic ultrasound examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 240 cases met the criteria. The leading fillers previously injected were 50.4% hyaluronic acid, 18.8% poly\u2010L\u2010lactic acid, 8.3% polymethylmethacrylate, 6.3% calcium hydroxyapatite, and 3.8% silicone oil. The main regions of granulomas were the lower lid, infraorbital, and medial cheek in 41.7%, the perioral region and lips in 19.2%, the lateral jaw and cheek in 14.6%, and the chin, pre\u2010jowl, and medial jaw in 12.5%. The layers involved by the granulomatous reaction were hypodermis in 37.1%, the deep fat pad in 8.9%, the periosteum in 5.8%, the combination of hypodermis, deep fat pad, and muscle in 5.8%, and the combination of hypodermis, fascia, subfascial, deep fat pad, and muscle in 5.4%. The predominant corporal locations were the face, submandibular, and anterior neck, with 95.8% being 87.5% in the face.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ultrasound can provide valuable and detailed anatomical information supporting diagnosis and management as well as valuable insights into the granulomatous reactions to fillers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jum.16700","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T19:11:20Z","timestamp":1743880280000},"page":"1447-1455","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["International Multicentric Study on Ultrasound Characteristics, Layer Location, and Corporal Distribution of Granulomas After Cosmetic Fillers Injections"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3359-5023","authenticated-orcid":false,"given":"Ximena","family":"Wortsman","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Universidad de Chile  Santiago Chile"},{"name":"Department of Dermatology, School of Medicine Pontificia Universidad Catolica de Chile  Santiago Chile"},{"name":"Department of Dermatology, Miller School of Medicine University of Miami  Miami Florida USA"},{"name":"Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yessenia","family":"Valderrama","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Ortiz\u2010Orellana","sequence":"additional","affiliation":[{"name":"Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Highly Specialized Ultrasound Center  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"de Cabo","sequence":"additional","affiliation":[{"name":"Centre M\u00e8dic de Cabo Bov\u00e9  Martorell Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0676-4020","authenticated-orcid":false,"given":"Stella","family":"Desyatnikova","sequence":"additional","affiliation":[{"name":"Private Practice, Facial Plastic Surgery The Stella Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Aquino","family":"Cavallieri","sequence":"additional","affiliation":[{"name":"Cavallieri Clinic  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Barrera","sequence":"additional","affiliation":[{"name":"Aesthetic Clinic  Entre Rios Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Sigrist","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine University of S\u00e3o Paulo  S\u00e3o Paulo 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