• Aesthetic surgery journal · May 2015

    Randomized Controlled Trial Comparative Study

    A blinded, randomized, split-face pilot study of bruising and pain with hyaluronic acid for correction of perioral lines using no lidocaine, lidocaine alone, and lidocaine and epinephrine.

    • Amir Moradi, Azadeh Shirazi, Jeanette Moradi-Poehler, Jessica Turner, and David J Howell.
    • Dr Moradi is a facial plastic surgeon, Ms Moradi-Poehler is a certified clinical research coordinator, and Ms Turner is a nurse in private practice in Vista, California. Dr Shirazi is a Clinical Dermatologist at Scripps Green Hospital, La Jolla, California. Dr Howell is a medical communications specialist in San Francisco, California.
    • Aesthet Surg J. 2015 May 1; 35 (4): 443-55.

    BackgroundHyaluronic acid (HA) fillers are sometimes mixed with lidocaine to mitigate pain. Whether the addition of epinephrine to lidocaine provides greater benefits in bruising and pain has not been fully reported.ObjectivesThe investigators explored the severity of bruising and pain in patients treated with the cohesive polydensified matrix HA (CPMHA) in 3 different preparations: CPMHA (Belotero Balance [BEL]), CPMHA with lidocaine (BEL-L), and CPMHA with lidocaine and epinephrine (BEL-LE).MethodsIn a blinded, split-face, 14-day study, 30 patients were divided into groups of 10. One group received 1.0 mL BEL in the perioral lines on 1 side and 1.0 mL of BEL-LE on the other side. A second group received 1.0 mL of BEL on 1 side and 1.0 mL of BEL-L on the other side. The third group received 1.0 mL of BEL-L on 1 side and 1.0 mL of BEL-LE on the other side. Over 3 visits, the treating investigator, the patients, and a blinded investigator rated the bruising.ResultsBruising occurred in each treatment group by day 1 but resolved for half of the patients by day 7 and for all patients by day 14. Split-face comparison did not reveal a significant difference in pain and bruising scores among the 3 preparations.ConclusionsNo significant difference was found in bruising or pain in patients treated with BEL, BEL-L, and BEL-LE. Studies with a considerably larger sample size are warranted to determine statistically significant and clinically meaningful differences between and among the various formulations.© 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

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