MRI for the evaluation of facial temporary and permanent cosmetic dermal fillers

PURPOSE: Cosmetic tissue augmentation and correction of skin depression using injectable material is a constantly growing worldwide non-surgical procedure. The aim of our study was to investigate and describe the MR aspects of diverse temporary and permanent dermal fillers injected in subcutaneous tissue of the face. METHOD AND MATERIALS: We have evaluated with MRI 10 normal volunteers undergone injection of temporary dermal fillers in the previous 4 months preceding the exam and another 9 who underwent injection of permanent dermal fillers in the previous 2-3 years. 9 patients with local complications after the injection of permanent fillers were also evaluated with MRI. All the exams were performed with a 1.5T superconductive magnet using Gradient-Echo T1-weighted, FSE T2-weighted with or without fat saturation (TI=150ms) on axial plane with a slice thickness of 3 mm. We also performed TIRM sequences using a TI of 130 ms, specific for silicone material and in all the patients with local complications axial FSE T1-weighted scans with fat-saturation after the i.v injection of a paramagnetic contrast agent were acquired. RESULTS: In all the normal volunteers it was possible to visualize the filler in the facial subcutaneous soft tissue. T2-weighted scans with fat saturation showed the best contrast to noise ratio and was considered the best MR acquisition in the evaluation of dermal fillers. In complicated cases it was possible to detect a diffuse edema at the site of the injection in 4 patients visualized on T2-weighted scans with fat saturation and in 2 patients a diffuse contrast enhancement of the subcutaneous tissues was detected due to an active inflammatory process. CONCLUSION: MRI has proved to be a useful tool in the identification of subcutaneous facial filler injection for cosmetic purposes and in the evaluation of possible soft tissue adverse reactions. CLINICAL RELEVANCE/APPLICATION: MRI has proved to be a useful tool in the identification of subcutaneous facial filler injection for cosmetic purposes and in the evaluation of possible soft tissue adverse reactions.