Evidence map›Paper›PMID 41494527›Full record

ArticlePlastic and reconstructive surgery2026

Ultrasound Evaluation of Lip Anatomy and Filler Placement: A Cross-Sectional Study of Injection Accuracy, Migration, and Demographic Variation.

Steven Harris, Leonie Schelke, Madara Orlovska, Ximena Wortsman, Sebastian Cotofana, Peter Velthuis

Abstract readMulticenter Study
In one paragraph

Article in Plastic and reconstructive surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Steven HarrisFrom private practice.
Leonie SchelkeDepartment of Dermatology, Erasmus Medical Center.
Madara OrlovskaFrom private practice.
Ximena WortsmanFrom private practice.
Sebastian CotofanaDepartment of Plastic Surgery, Vanderbilt University Medical Center.
Peter VelthuisDepartment of Dermatology, Erasmus Medical Center.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLip fillers composed of hyaluronic acid are commonly used for aesthetic enhancement, yet the anatomical changes they induce and their relationship to demographic factors remain incompletely understood.

methodsA cross-sectional study of 126 participants was conducted at clinics in London and Amsterdam. High-frequency ultrasound was used to assess lip layer thickness, submucosal gland dimensions, and filler position. Demographic data were recorded and correlated with anatomical findings and filler distribution.

resultsTreated patients demonstrated significantly increased thickness in the connective tissue and pars peripheralis layers. The subcutaneous layer averaged less than 1 mm in both upper and lower lips, resulting in intramuscular filler placement in most treated individuals. Vertical injection techniques were associated with deeper filler deposition, hypervascularity, and evidence of migration. Lip anatomy varied significantly with sex, race and ethnicity, body mass index, and age.

conclusionsHyaluronic acid fillers alter lip anatomy in measurable ways, often resulting in unintended intramuscular placement due to the limited subcutaneous space. Demographic factors significantly influence lip structure and filler behavior, supporting the need for individualized treatment planning. Future studies should investigate long-term outcomes and patient perspectives.

Indexed as

Dermal FillersForeign-Body MigrationHyaluronic AcidLipLip AugmentationAdultAgedCosmetic TechniquesCross-Sectional StudiesFemaleHumansMaleMiddle AgedUltrasonographyDermal FillersHyaluronic Acid

Identifiers

PMID41494527
PMCPMC13290038

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.