WFUMB Position Paper: Consensus on Best Practice in Aesthetic Dermatologic Ultrasound

This position paper from the World Federation for Ultrasound in Medicine and Biology (WFUMB) reviews dermatologic ultrasound applications in the aesthetic field, providing best practices. Although dermatologic ultrasound for aesthetic applications has been demonstrated to be useful, there is little information about standardized protocols for equipment, techniques, nomenclature, reporting, documentation, training, safety, and guided procedure. To address these gaps, a group of experts consolidated the current knowledge based on published evidence and their experience. The objective is to enhance and standardize dermatologic ultrasound in the aesthetic field, facilitating accurate diagnoses and ultimately improving patient management and outcomes. Two rounds of questionnaires were developed by the steering committee co-moderators to identify key issues in aesthetic ultrasound. Authors participated in virtual voting using multiple-choice questions covering technical and procedural topics. Results were discussed in a consensus meeting. Position statements were accepted if >75% of votes supported them, categorized as broad agreement (75-95%) or strong consensus (>95%). Topics with 50-75% agreement were considered majority consensus. Statements with ≤50% agreement or repeated failure to reach consensus were excluded. Drawing on the responses to the questionnaires and the overall consensus of this panel of experts, a total of 24 recommendations were formulated. In conclusion, the recommendations in this position paper are designed to support the goal of standardizing examinations, providing a foundation for their implementation in both clinical practice and scientific research.