Hyaluronic acid dermal fillers: can adjunctive lidocaine improve patient satisfaction without decreasing efficacy or duration?

Abstract

Hyaluronic acid (HA) dermal fillers are the most widely used injectables to augment facial volume without surgery. HA dermal fillers are popular because of their ease of administration, predictable effectiveness, good safety profile, and quick patient recovery. The most common patient complaint is pain. Our goal is to review the current literature on HA fillers and compare outcomes with and without lidocaine. We found adjunctive lidocaine significantly decreases pain during injection and postinjection with corresponding increased patient satisfaction. The efficacy and safety profile appears unchanged. Rare complications with HA fillers and those associated with constituents of the product, contaminants, and lidocaine are reviewed. The corrective effects of HA fillers are temporary; repeat treatment is required to maintain results. Minimizing pain is crucial to optimize patient satisfaction.

Investigation of Physical Properties of a Polycaprolactone Dermal Filler when Mixed with Lidocaine and Lidocaine/Epinephrine

“…In addition, previous studies have shown that the addition of lidocaine to collagen-based dermal fillers resulted in less swelling and bruising [17], potentially due to the antihistaminergic effect of lidocaine on mast cells [18]. Similar findings have been reported for hyaluronic acid-based dermal fillers mixed with lidocaine, also showing a reduction in swelling, erythema, and bruising [16, 19–21]. As lidocaine is suggested to decrease these side effects, this is also expected for the PCL-based dermal filler mixed with lidocaine.…”

“…Physicians have reported no decrease in clinical efficacy after mixing the PCL dermal filler with lidocaine with or without epinephrine, as has also been reported for hyaluronic acid-based dermal fillers containing lidocaine (for review, see Smith and Cockerham [21]). Planned (pre)clinical studies with lidocaine premixed before treatment and lidocaine incorporated in the PCL dermal filler syringe itself are aimed at confirming this.…”

Cohesive Polydensified Matrix^® hyaluronic acid volumizer injected for cheek augmentation has additional positive effect on nasolabial folds

“…Studies have shown that lidocaine integrated into the filler reduced the perception of pain during the injection and correlated with higher patient satisfaction. 26 Although injection site reactions such as redness, swelling, and bruising are expected with any type of dermal filler injection, 17 only 1 event of redness was reported. Consistently, most patients in the present study stated their willingness to repeat the procedure.…”

A Review of the Metabolism of 1,4-Butanediol Diglycidyl Ether-Crosslinked Hyaluronic Acid Dermal Fillers

“…Hyaluronic acid has a long history of cosmetic use; in 1989, Balasz and Denlinger described the first HA developed as a dermal filler,1,36 and HA dermal fillers have been used for soft tissue augmentation since the 1990s 1. The first BDDE-crosslinked HA filler was made available in Europe in 1996, and since then the safety profile of this type of product has been extensively studied.…”

“…The technology and biocompatibility of the products has progressed along with this demand, from the use of silicone injections in the 1940s and 1950s and the first animal-derived collagen fillers of the 1980s through to the introduction of hyaluronic acid (HA) fillers in the 1990s 1. HA fillers, according to a survey of plastic surgeons conducted by the International Society of Aesthetic Plastic Surgeons (ISAPS), were the second-most-popular nonsurgical procedure of 2010, with more than two million procedures performed 2.…”