Which type of MRI would be best to detect old filler?

Question

I received HA filler from an unqualified injector three years ago. The results were horrible, so I paid hundreds to have it dissolved by a plastic surgeon. Still, a lot of the filler remains and I would like it all dissolved. To do this I would like to first order an MRI to detect exactly where the filler is. I have a way to request an MRI, but I don’t know what specific type I should order. Any advice?

James M. Economides, MD, FACS · Answer

To detect the exact location of residual hyaluronic acid (HA) filler, an MRI can be helpful. The type of MRI you would need depends on the filler material, but for hyaluronic acid fillers specifically, here's what to consider:

1. Type of MRI:
High-Resolution MRI: This is typically recommended for soft tissue evaluation. A 3 Tesla (3T) MRI machine offers a higher resolution and more detailed images, which can help differentiate between filler, fat, and natural tissue.

Fat-Suppressed MRI: Since HA fillers are often used in soft tissues that contain fat, requesting a fat-suppressed MRI can help better visualize the filler by reducing the signal from the surrounding fat.

Non-Contrast MRI: For most HA fillers, a non-contrast MRI is typically sufficient to visualize the material, so you likely don’t need contrast unless recommended by your radiologist or provider.

2. Specific Area to Scan:
Be specific about the areas where you believe the filler remains (e.g., cheeks, lips, under-eye area), so the MRI can focus on those regions. This can provide more detailed imaging for the areas of concern.
3. Consult with a Radiologist or Plastic Surgeon:
It's always a good idea to consult with a radiologist or plastic surgeon beforehand to ensure you're ordering the appropriate type of MRI for detecting filler. They can provide more specific guidance based on your case and areas of concern.
Once the MRI identifies where the filler remains, you can proceed with a targeted plan for dissolving the remaining product.

Lexie Wang, MD · Answer

You want an MRI of the area injected (assuming it was your face, it'll be a MRI head/brain usually, depending on the order set), you should not NEED contrast unless you really think it was a weird substance, and I would specifically state "reason for exam: ________" (check for cheek filler) or something so that the radiologist /techs know what to target and what they're looking for.

Shabnam Ghazizadeh, MD · Answer

Hi @Imaginative161897, Sorry to hear about your experience. Most likely an MRI face WITH contrast would be best. Best of luck, Dr. Ghazizadeh

Which type of MRI would be best to detect old filler?

Answers (3)

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