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UPDATE: I can no longer recommend this product. I would suggest using Restylane®, Perlane® or Juvederm®. All three are now available with Lidocaine, all three seem to have fewer adverse reactions and superior customer service. Please see “The Ugly” below for details.

I previously posted articles on what’s new in Plastic Surgery San Francisco including two new cosmetic plastic surgery products: Hydrelle® and Dysport®. Well, there is new information to share with both products. The scoop on Hydrelle® is here … Dysport there.

Hydrelle the first FDA approved wrinkle filler with a numbing agent added.

Hydrelle®: the first FDA approved wrinkle filler with numbing added.

Hydrelle® was featured on the hit television series The Doctors.

I have had a chance to use Hydrelle® and it is easy to work with. It is very similar to Restylane®, Perlane® and Juvederm®. If you are familiar with these dermal fillers, the results last for about the same amount of time; however, Hydrelle® is more concentrated.

The Good, the Bad and the Ugly

The good news is that Hydrelle® requires about half the volume of the other products for wrinkle correction. Similar correction, half the volume. Moreover, the local anesthetic (0.3% lidocaine), which is added to Hydrelle®, really cuts down on the discomfort of the injections. While I almost always use a local anesthetic block to administer the current HA fillers, with Hydrelle® I rarely need to block the area before treating.

The bad news is that the concentrated product tends to swell more than the others dermal fillers. This is most apparent the first day or two, and then it settles down. Also, if you are allergic to sulfites (red wine or dried fruit) this product is not for you.

The Ugly

EDIT: Three to four weeks after injecting a patient with Hydrelle® they developed two large sterile abscess on the cheeks which required weeks of antibiotics, steroids, and surgical drainage to treat. This complication is rare, but other examples can easily be found on line. The injection was in the nasolabial folds and technique used was as recommended by the manufacturer, and the same technique I use with the other HA fillers (Restylane®, Perlane® and Juvederm®) This patient’s cultures were negative and they were not allergic to Sulfites.

If I continued to use Hydrelle®, I might go the rest of my career without seeing this extreme reaction again; however, the only way I can be 100% certain the Hydrelle® will not cause more problems in my practice is to no longer use the product. Good, safe and time tested alternatives are available with and without Lidocaine: Restylane®, Perlane® and Juvederm®.

The FDA is currently reviewing this and other reports of adverse reactions submitted regarding Hydrelle®, and for now it remains on the market. I was very excited about this product as it seems to fill better than the other fillers; however, I will no longer be offering Hydrelle® in my Walnut Creek Plastic Surgery office.

I have used HA fillers since they became available in the US, and I have never seen this type of delayed onset and prolonged recovery with any other HA product, and I hope I never do again. Complications can occur with any procedure, so if you develop redness, lumps, pain, increasing swelling, or any other signs of an adverse reaction, be certain to contact your plastic surgeon immediately.

All adverse reactions, for any product not just Hydrelle®, should be reported to the FDA. The FDA’s online submission form is here. My patient sample size is too small to draw any conclusions, and the FDA is there to compile this data and make the appropriate recommendations. If you have had an adverse reaction, you should submit it. The FDA will compare the number of adverse reactions to the number of units sold to see if it is an acceptable number.

Please understand, my results may not be typical, and others will hopefully never have this type of reaction. My only goal in suppling the above information is to improve patient safety.

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