Effect of Adding Lidocaine to Hyaluronic Acid Gel for Volume Loss Correction: A Preliminary Observation

Introduction: Although adding a local anesthetic is an effective way to reduce pain during intradermal Hyaluronic Acid (HA) injections, it is not clear if the pain control is as effective when performing injections close to the bone. The primary aim of these preliminary observations was to explore this issue. As a secondary aim, we wanted to assess if the addition of lidocaine alters the behavior of HA gel in the tissues over time. Subjects: Two women provided informed written consent to participate in the study. Participants were blind to the type of HA gel used for either temporal fossa. Methods: A cross-linked HA gel was used for the study. One side was injected with the gel with and the other without lidocaine, in no particular order. Photographs from the front, profile and three-quarter left and right and frontal MRI scans were taken before and just after the injections, then every 6 months for 2 years. Results: The side injected with the gel with lidocaine was significantly less painful than that injected without lidocaine. Both types of gel changed shape on MRI in the first 6 months but stayed stable thereafter till the end of our follow-up at 24 months. Based on MRI, patient reported outcomes and expert assessed aesthetic outcomes, using MAS® and the global aesthetic improvement scale, both types of gel were comparable. Conclusion: The addition of lidocaine to HA volumiser gels reduces pain to a remarkable degree.