PhD ceremony Ms. F.R. Grippaudo: Imaging in dermal fillers

PhD ceremony: Ms. F.R. Grippaudo, 12.45 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Imaging in dermal fillers

Promotor(s): prof. A. Signore, prof. N. Scuderi

Faculty: Medical Sciences

The main topic of this thesis is the diagnostic roles of imaging techniques in dermal filler evaluation. Dermal fillers are products used to enhance soft tissues for cosmetic purposes, differing in composition and durability within the soft tissues. Complications occur that show as product migration, acute or recurrent soft tissue oedema, infection, granuloma, fistulae or fibrosis. My original contribution was to clarify the role of High Frequency Ultrasound as a first line exam to ascertain the presence of a dermal filler within the soft tissues even if not evident at clinical exam, measuring its extent and nature (different injected materials may require different treatments). Recognizing the presence of a dermal filler is of paramount importance since interactions between different fillers may cause complications. The next step was to evaluate the role of MRI in dermal filler imaging as a useful and non-invasive tool: if complication occurs, Gadolinium administration is advised for better characterization of the lesion. MRI allows the visualization of dermal fillers with respect to the anatomical structures of the face, thus easing the surgical planning in case of removal. The last innovative element of this thesis was to demonstrate the role of scintigraphy with 99mTc-labelled white blood cells for the differential diagnosis between infective processes and inflammatory reactions, in order to offer the best treatment plan to patients presenting with dermal filler complications.