Background <p>High-frequency ultrasound is commonly used for evaluating breast filling materials and can be used to diagnose adverse reactions after breast augmentation procedures.</p> Methods <p>Breast ultrasound images obtained at the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College from January 2015 to February 2023 were analyzed and evaluated.</p> Results <p>A total of 595 patients who underwent breast augmentation procedures were included in this study: 195 patients underwent prosthetic breast augmentation; 308, autologous fat filling; 77, polyacrylamide hydrogel filling; 12, expander implantation; and 2, silicone oil filling. Ultrasound could reveal complications such as intracapsular rupture, extracapsular rupture, folding, fluid accumulation, and infection after prosthesis implantation. Ultrasound could also show pathological manifestations such as necrosis, calcification, and infection of autologous fat after autologous fat transplantation and displacement, extravasation, calcification, and infection after polyacrylamide hydrogel implantation.</p> Conclusions <p>High-frequency ultrasound plays an important role in the identification of breast filler materials and the diagnosis of complications after breast augmentation procedures.</p> Level of Evidence II <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors&#xa0;<a href="http://www.springer.com/00266">www.springer.com/00266</a>.</p>