Ultrasound guidance is emerging as a critical tool for medical spas and aesthetic practices to improve patient safety and reduce risks associated with dermal filler injections.
A study presented at the Radiological Society of North America (RSNA) 2025 Annual Meeting highlights how ultrasound can pinpoint and treat vascular occlusions caused by cosmetic fillers.

Researchers evaluated 100 patients with filler-related vascular complications across four radiology centers (Brazil, Colombia and Chile), one dermatology center (Netherlands) and one plastic surgery center (U.S.) between May 2022 and April 2025. Among these cases, 42% showed absent blood flow to perforator blood vessels that connect superficial and deep facial arteries, while 35% had absent flow in major vessels, often involving the high-risk lateral nasal artery.

Misplaced filler can block blood flow, leading to severe outcomes such as necrosis (tissue death), facial deformity, blindness, or even stroke. Hyaluronidase injections remain the standard for dissolving hyaluronic acid fillers, but ultrasound guidance allows clinicians to target occlusions precisely, reducing the amount of enzyme needed and improving patient outcomes. Beyond treatment, ultrasound can also guide initial filler placement, minimizing complications and improving precision.

"If injectors are not guided by ultrasound, they treat based on where the clinical findings are and inject blindly," said lead author Dr. Rosa Maria Silveira Sigrist.. "But if we can see the ultrasound finding, we can target the exact place where the occlusion occurs. Rather than flooding the area with hyaluronidase, we can do guided injections that use less hyaluronidase and provide better treatment results."

Why this matters for medical spas

Adopting ultrasound technology in medical spas can enhance patient safety by reducing severe complications and helping practitioners to quickly and accurately respond when vascular blockages occur. Florida already mandates ultrasound for gluteal fat grafting procedures, and states may take notice with similar regulations for facial injectables.

Offering ultrasound-guided injections positions your med spa as a leader in advanced safety protocols, which can differentiate your practice in a competitive market. Investing in ultrasound technology may require upfront costs, but the reduced liability, improved outcomes and enhanced patient trust can significantly impact your bottom line.

Ultrasound and patient safety

Ultrasound guidance is becoming the gold standard for safe, effective filler treatments. Medical spa practitioners who use ultrasound to visualize the anatomy have an advantage when it comes to protecting patients.

AmSpa strongly advocates for proper aesthetic injector training in facial anatomy and complication management. Members can access hands-on, intensive training courses such as the Academy for Injection Anatomy (AIA) Advanced Cadaver Course and Ultrasound Fundamentals for the Aesthetic Injector, as well as virtual technique training. Explore our injector training here.

Further Reading:

How Safe Med Spas Manage Complications 

Ultrasound in Aesthetics: Bringing Ultrasound into Your Medical Spa 

Ultrasound-guided Techniques for Rapidly Dissolving Misplaced Facial Fillers 

Injectables Safety: What Patients Should Know About Dermal Filler and Neurotoxin