Restylane-L Injected W/ Extra Lidocaine and Epinephrine; Is This Safe?

Question

I recently consulted with a board certified facial plastic surgeon about Restylane injections in the lower eyelid/upper cheek area. He explained to me that he uses Restylane-L and also mixes in some additional lidocaine and epinephrine to reduce the possibility of bruising. This sounds great, but it also makes me nervous adding in multiple compounds and increasing the probability of a reaction. Is this a common practice for Restylane injections, and is it anything at all to be concerned about?

Sam Naficy, MD, FACS · Answer

If you are having treatment with a reputable and well-trained provider, I would trust they have your best interest in mind when adding lidocaine with epinephrine to the product to help minimize bruising in this area. It's not an uncommon practice.

Scott Trimas, MD · Answer

There is no evidence that diluting the fillers with these added products will cause any harm and could make the procedure less painful and possibly result in less bruising. That being said I have found that sometimes diluting the product decreases the duration of the effect but other than that does no additional harm.

Kenneth D. Steinsapir, MD · Answer

There is no evidence that this reduces the risk of bruising. The risk comes when you are poked by a needle. The injection of this local itself can cause a big bruise. The best way to reduce the risk of getting a big black eye is to avoid medications and herbal products that inhibit platelets for about 3 weeks prior to being injected. Even still the risk is not zero.

Joel Schlessinger, MD · Answer

I have done this for over 4 years now and it has made all the difference in my patients' experiences with fillers. It is an incredible benefit as it reduces bleeding and pain significantly and is MUCH better than just the lidocaine alone. It is a shame that the companies didn't add epinephrine to it as that would have made their products even better, but they went for lidocaine alone and that can sometimes end up with more bruising than even the older fillers with nothing. So I would definitely go for it. Enjoy!

Steven Wallach, MD · Answer

I do exactly what you described for fillers in the tear troughs to minimize the risk of lumps and to minimize the risks of bruising. I will often use ice packs as well after injection.

Restylane-L Injected W/ Extra Lidocaine and Epinephrine; Is This Safe?

Answers (8)