Kenneth Beer, M.D. is a board-certified dermatologist and dermatopathologist in Palm Beach, Fla., and the director of, an online skincare company. He is also the director of The Cosmetic Bootcamp, which trains physicians in best practices for cosmetic medicine. Dr. Beer is an instructor in dermatology at the University of Miami, and he is an A.B. Duke Scholar at Duke University. He obtained his medical degree from the University of Pennsylvania School of Medicine, and received his dermatology and dermatophathology training at the University of Chicago. Visit Dr. Beer's office at

Wrinkle Cures With Less Pain

Tuesday, 11 September 2012 07:32 AM

Recently, the FDA approved several new facial fillers that contain local anesthetic. Each is a variation of an already approved product with lidocaine added to make the treatments more comfortable.
In countries where these are already in use, patient demand for the newer version of these wrinkle-correcting treatments has greatly increased.
Recently approved for the U.S. are Restylane L and Perlane L from Medicis and Juvederm XC from Allergan. These join the other filler containing lidocaine, Prevelle Silk, manufactured by Mentor.
Restylane L and Perlane L are hyaluronic acids used for filling lines including the nasolabial crease (the “parentheses” around the nose to the mouth), marionette lines (straight lines from the corners of the mouth to the chin) as well as for soft tissue augmentation of the lips, eye area, chin, cheeks, and jowls. They tend to be good for lifting and sculpting and results last about six months.
Each is similar to the products that did not have lidocaine, so for people who are familiar with these, the change will mean increases comfort with the same effectiveness. The amount of lidocaine in each is 0.3 percent, which is enough to create a significant increase in comfort for about an hour.
Juvederm XC and Juvederm Plus XC also contain anesthetic and are similar to the versions that have been used for years. These contain 0.3 percent lidocaine as well.
One clinical trial performed in France using this product demonstrated that a majority of patients given the choice between the version with or without anesthetic chose the one with, and few would switch back to the version without it.
I expect that many of my patients getting injections into their nasolabial creases and marionette lines will be fine with the new formula. Patients who need a little more comfort will be able to sit before the injections with some topical anesthetic. For lips, I plan to still use some local anesthetic similar what a dentist uses so that my patients have a good experience.
There are a few potential drawbacks to the newer products. The first is that some patients do not like the sensation of being numb or feel claustrophobic when they get anesthetic at the dentist. Another, less likely one is that the lidocaine may cause a slight increase in bruising.
Advances in cosmetic dermatology occur constantly. Many are insignificant, but some are actually helpful. These new products are worthwhile and I suspect that patient comfort will be significantly enhanced.
To learn more about Dr. Beer, visit and

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New facial fillers with added local anesthetic make wrinkle procedures significantly less painful.
Tuesday, 11 September 2012 07:32 AM
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