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Clinical cases and the latest research from Journal of the American Academy of Dermatology (JAAD), JAAD Case Reports, JAADi, and JAAD Reviews.
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Are spicules actually safe for your skin? We ask @dermangelo to weigh in on the recent paper from the Journal of the American Academy of Dermatology @jaadjournals that raised concerns about “liquid microneedling” spicules and potential skin reactions like granulomas👇 Link in bio for the full conversation #breakingbeautypodcast #spicules #reedleshot #skincaretips #microneedling
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Ethics in practice. 
Where do you draw the line?

#filler #dermatology
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🔬 New publication in JAAD! 🎉
I'm happy to share our new article, “Color Doppler Ultrasound of Cosmetic Filler Complications: Associations with Filler Type and Injector Profession,” recently published online as a pre-proof in the Journal of the American Academy of Dermatology (JAAD).
In this study of 89 patients with filler-related complications, color Doppler ultrasound provided valuable information about filler type, location, and associated complications. Interestingly, 41.6% of patients did not know which filler had been injected, and in 37% there was a mismatch between the reported filler history and the ultrasound findings—highlighting the limitations of clinical history alone and the value of imaging before treatment.
🔎 Some key findings:
🔹 Hyaluronic acid was the most frequently identified filler (57.3%).
🔹 Common ultrasound findings included complex filler deposits with inflammatory changes (33.7%), granulomas (28.1%), panniculitis (23.6%), fluid collections (22.5%), and vascular complications (13.7%).
🔹 Vascular complications occurred exclusively with hyaluronic acid fillers in this cohort.
🔹 A particularly interesting finding was the association between complication timing and injector profession (p<0.001). Among the early complications (≤4 weeks), 62% occurred after injections by non-physicians, 31% after injections by non-dermatologist physicians, and 6% after injections by dermatologists. In contrast, among late complications (>4 weeks), 40% followed injections by dermatologists, 40% by non-dermatologist physicians, and 20% by non-physicians.
Importantly, these percentages should not be interpreted as complication rates for each professional group, since the study included only patients who had already developed complications.
Our results support ultrasound as a first-line modality for identifying filler type and clarifying the pathophysiologic basis of adverse outcomes, reinforcing its growing role in assessing and managing cosmetic filler complications.
Congratulations to the entire team involved in this work!
Reference: Etesami I, Memari H, Wortsman X, Taghavi A, Hosseini F, Khorasanizadeh F. Color Doppler Ultrasound of Cosme
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