STYLAGE® XL BI-FLEX® with Lidocaine

It is a CE-marked, injectable hyaluronic acid (HA) dermal filler containing 26mg/g HA, the highest concentration in the STYLAGE range, and 3mg/mL lidocaine. Manufactured by Laboratoires VIVACY in France, it features IPN-Like Technology™ and the updated ergonomic BI-FLEX® syringe system (formerly Bi-SOFT®), packaged in a teal-and-white box.

It is indicated for correcting severe facial volume loss and for performing deep structural contouring in areas such as the cheeks, temples, midface, chin, and jawline. It is also utilized as a deep base layer for severe nasolabial folds and marionette lines.

Select STYLAGE XL when the required deep structural support or volume deficit exceeds the capabilities of lighter formulations. By comparison, STYLAGE S targets superficial lines, STYLAGE M and L address moderate wrinkles and intermediate volume loss, and specialized formulations serve perioral/lip indications.

The co-formulated 3mg/mL lidocaine minimizes the acute procedural discomfort inherent to deep subcutaneous and supraperiosteal injections. Attenuating local nociceptive signaling eliminates the need for a secondary anesthetic step, saving procedural time and improving patient tolerance. Screen for amide-type local anesthetic hypersensitivity before use.

The underlying filler formulation has not changed, but it was previously paired with the Bi-SOFT® delivery system. The BI-FLEX® designation indicates the updated, rebranded syringe design engineered for better ergonomics, precision, and safety.

In vivo longevity depends on the treatment area, injection technique, muscle movement, tissue quality, and patient lifestyle. Because it is placed in deeper anatomical planes, its duration profile differs from that of superficial fillers; practitioners should refer to the product instructions for use (IFU) for the expected clinical timeline.

No. STYLAGE products are CE-marked for use in the European Union and other international regions, but they are not approved by the US Food and Drug Administration (FDA). Regulatory status must be verified independently based on your local jurisdiction before procurement.

Typical local injection-site reactions include erythema, edema, tenderness, bruising, pain, and mild induration, which generally resolve within a few days. Due to the deep injection depth, swelling may be more pronounced than with superficial treatments. Immediate clinical evaluation is mandatory if a patient presents with worsening pain, blanching, livedo reticularis, or visual disturbances.

Citations

1. Mojallal A. Efficacy and Safety of Stylage XL Lidocaine for the Restoration and/or Augmentation of Facial Volume: The Beauty Volume Study. Aesthet Surg J Open Forum. 2023;5:ojad056. Published 2023 Jun 26. doi:10.1093/asjof/ojad056
2. Ordynowski Ł. Cross-Linked Hyaluronic Acid for Cleft Lip and Palate Aesthetic Correction: A Preliminary Report. Aesthet Surg J Open Forum. 2022;4:ojac052. Published 2022 Jun 8. doi:10.1093/asjof/ojac052
3. Pantermehl S, Foth A, Meyer E, Barbeck M, Jung O. In Vitro Cytocompatibility Analysis and Comparison of Different Hyaluronic Acid Fillers for Minimally Invasive Esthetics. In Vivo. 2024;38(4):1621-1635. doi:10.21873/invivo.13612

For licensed medical professionals only. This content is for informational purposes only and does not constitute medical advice.