Dr. Tom McCann, a board-certified diagnostic radiologist, and Alexandra explain what imaging shows about hyaluronic acid filler years after injection: a 2024 MRI study that found filler in all 33 midface patients studied, one at about 15 years; what filler looks like on MRI, ultrasound and CT; a 2026 case in which MRI found chin filler that two ultrasounds missed; a 2026 case of upper eyelid swelling traced to temple filler from two years earlier; and the realities of dissolving filler with hyaluronidase.
Key facts. Master 2024: 33 patients (24 asymptomatic, 9 with edema concerns), HA visible on MRI in all; 12 not injected for more than 5 years; longevity up to about 15 years; small, selected cohort. Mariluis 2026: persistent chin pressure 2 years after high-G-prime HA; two high-frequency ultrasounds showed only a small supraperiosteal bolus; MRI showed diffuse HA in subcutaneous fat; 150 IU targeted hyaluronidase gave complete relief, confirmed on follow-up MRI. El Feghaly and Tawa 2026: bilateral upper eyelid edema with unremarkable labs and orbital MRI; blepharoplasty histology showed HA; temple filler 2 years earlier recalled after surgery. Elective use of hyaluronidase to dissolve filler is off-label.
The voices in this episode were generated with AI (ElevenLabs). Dr. McCann reviews every script.
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Coming January 12, 2027: Imaging the Filler Complication, Dr. McCann's online course on reading filler on ultrasound, MRI and CT. Join the waitlist for the founding price: https://claude.ai/artifact/KNPp4Wn1wLPz4YdmaDoS1o
References
- Master M, Azizeddin A, Master V. Hyaluronic acid filler longevity in the mid-face: a review of 33 magnetic resonance imaging studies. Plast Reconstr Surg Glob Open. 2024;12(7):e5934. https://doi.org/10.1097/GOX.0000000000005934
- Mariluis CA, Lagonegro D, Cavallieri F, Barrera P. Where is the filler? Magnetic resonance imaging reveals hidden hyaluronic acid in a delayed chin complication. Plast Reconstr Surg Glob Open. 2026;14(1):e7412. https://doi.org/10.1097/GOX.0000000000007412
- El Feghaly C, Tawa P. Late-onset upper eyelid edema following temporal hollow correction with hyaluronic acid. Plast Reconstr Surg Glob Open. 2026;14(4):e7612. https://doi.org/10.1097/GOX.0000000000007612
- DeLorenzi C. New high dose pulsed hyaluronidase protocol for hyaluronic acid filler vascular adverse events. Aesthet Surg J. 2017;37(7):814-825. https://doi.org/10.1093/asj/sjw251
What is The Artemis Podcast?
A radiologist who injects walks through aesthetic medicine with the evidence. Dr. Tom McCann, a board-certified radiologist and the physician at Artemis Modern Aesthetics in Medford, New Jersey, and Alexandra cover neuromodulators, fillers, GLP-1 medicines, skin science and devices, one primary source at a time. The voices in this show are generated with AI using ElevenLabs. Tom writes and reviews every script, and the sources are in the show notes.