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

Figures & data

Table 1 Studies of HA fillers with and without lidocaine

Reference	Study type	Number of patients	Lidocaine concentration	Evaluation	Results	Complications and rate
Beasley et al^Citation2	Retrospective chart review	439 Patients, 498 injections	Luer-lock method: 0.1% lidocaine 1:10,000 epinephrine	Chart review of pain postinjection (rating 1–10)	No mean values published. 41 Patients bypassed subsequent topical/block with repeat injection	No adverse events, observed decrease in bruising per authors
Monheit et al^Citation4	Prospective, randomized, single-blind, controlled trial. NLF split-face comparison	45 Patients	Captique vs Prevelle SILK (0.3% lidocaine)	Patient VAS rated 0–10 cm	50% Less pain (P < 0.05)	No difference between treatment groups
Levy et al^Citation1	Prospective, randomized, double-blind, controlled trial. NLF split-face comparison	60 Subjects	Juvéderm Ultra 3 with and without 0.3% lidocaine	Patient VAS rated 0–10 cm, physician observation	Mean subject score 3.6 with vs 5.8 without lidocaine (P < 0.001).	No significant difference between outcomes of treatment groups
					Physician observed 81% patients with vs 36% without in pain (P < 0.001)
Levy et al^Citation1	Prospective, randomized, single-blind, randomized controlled trial. NLF split-face comparison	126 Subjects	Juvéderm Ultra 3 (0.3% lidocaine) vs Restylane–Perlane	Patient British Pain Scale (0–10 rating)	Lower pain scores with lidocaine (P < 0.0001). 95% patient preferred Juvéderm Ultra 3	More reports with Restylane–Perlane, particularly more reports of swelling without lidocaine
Lupo et al^Citation17	Prospective, randomized, double-blind, controlled trial. NLF split-face comparison	18 Subjects	Large particle hyaluronic acid with and without 2% lidocaine	Patient questionnaire, Canfield photography, blind physician evaluations	Significantly less pain with lidocaine per patients and Physicians	Trend toward less bruising and redness with lidocaine
Weinkle et al^Citation8	Prospective, randomized, double-blind, controlled trial. NLF split-face comparison	72 Subjects	Juvéderm with and without lidocaine (0.3%)	Patient 11-point pain scale	Mean score of 2.0 with vs 5.3 without (P < 0.001)	No significant difference between outcomes of treatment groups
Wahl^Citation18	Prospective case series	3566 Subjects	Juvéderm Ultra with 0.3% lidocaine	Patient British Pain Scale (0–10 rating)	Mean scores of 2.7, 1.4, 2.6 during injection, massage, and 5–10 min postinjection	No reportable adverse reactions

Abbreviation: VAS, visual analog scale.

BeasleyKLWeissMAWeissRASoft tissue augmentation using a two-way connector to supplement hyaluronic acid filler with 1% lidocaine hydrochloric acid with epinephrine 1:100,000: our experience and observationsDermatol Surg201036452452620402933

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MonheitGDCampbellRMNeugentHReduced pain with use of proprietary hyaluronic acid with lidocaine for correction of nasolabial folds: a patient-blinded, prospective, randomized controlled trialDermatol Surg20103619410120002638

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LevyPMde BoulleKRaspaldoHA split-face comparison of a new hyaluronic acid facial filler containing pre-incorporated lidocaine versus a standard hyaluronic acid facial filler in the treatment of naso-labial foldsJ Cosmet Laser Ther200911316917319337944

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LupoMPSwetmanGWallerWThe effect of lidocaine when mixed with large gel particle hyaluronic acid filler tolerability and longevity: a six-month trialJ Drugs Dermatol2010991097110020865841

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WeinkleSHBankDEBoydCMGoldMHThomasJAMurphyDKA multi-center, double-blind, randomized controlled study of the safety and effectiveness of Juvéderm injectable gel with and without lidocaineJ Cosmet Dermatol20098320521019735519

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WahlGEuropean evaluation of a new hyaluronic acid filler incorporating lidocaineJ Cosmet Dermatol20087429830319146607

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