STYLAGE® XXL BI-FLEX® with Mepivacaine

It is an injectable HA dermal filler with 21mg/g HA and 3mg/mL mepivacaine hydrochloride manufactured by Laboratoires VIVACY (France). It features IPN-Like Technology™ and the updated BI-FLEX® syringe system (rebranded from Bi-SOFT®) for extreme facial volume loss. It is CE-marked but not FDA-approved.

STYLAGE® XXL BI-FLEX® with Mepivacaine is used for extreme or severe facial volume loss, maximum-depth structural volumization, cheekbone augmentation, chin projection, and jawline contouring. It is indicated for cases where lighter formulations cannot achieve the required structural correction. Use depends on the degree of volume deficit, injection plane, and clinical assessment by an experienced aesthetic professional.

Mepivacaine hydrochloride offers a faster tissue onset and a more neutral pH profile than lidocaine, reducing injection-site discomfort at very deep subcutaneous and supraperiosteal planes. It also lacks a vasoconstrictor component and has a slightly shorter half-life in tissue, which may support precision and earlier assessment of outcomes at periosteal depth. Practitioners should review the mepivacaine profile and contraindications separately from lidocaine-containing STYLAGE® formulations before use.

The formulation itself remains unchanged, but the delivery mechanism was previously called the Bi-SOFT® syringe system. The BI-FLEX® rebrand marks an ergonomic and structural update to the physical syringe.

Typically 12 to 18+ months. Deep-plane placement over bony structures experiences less mechanical stress from muscle movement than superficial dermal layers, thereby prolonging degradation.

Yes. It is highly regarded in Europe and CE-recognizing markets for its unique rheology. The IPN-Like cross-linking provides excellent lifting capacity and cohesivity, meaning it holds its shape under heavy tissue load without migrating.

Common side effects include redness, swelling, tenderness, bruising at the injection site, pain, itching, firmness, or mild nodularity. These reactions typically resolve within a few days, though deep-plane swelling may be more pronounced and longer-lasting than with superficial formulations. Worsening pain, changes in skin color, blanching, livedo, or visual symptoms require urgent clinical evaluation.

Citations

1. Brusini R, Iehl J, Clerc E, Gallet M, Bourdon F, Faivre J. Comparative Preclinical Study of Lidocaine and Mepivacaine in Resilient Hyaluronic Acid Fillers. Pharmaceutics. 2022;14(8):1553. Published 2022 Jul 26. doi:10.3390/pharmaceutics14081553
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. Micheels P, Porcello A, Bezzola T, et al. Clinical Perspectives on the Injectability of Cross-Linked Hyaluronic Acid Dermal Fillers: A Standardized Methodology for Commercial Product Benchmarking with Inter-Injector Assessments. Gels. 2024;10(2):101. Published 2024 Jan 26. doi:10.3390/gels10020101

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