STYLAGE® XXL BI-FLEX® with Mepivacaine

Product Specifications

• Active Ingredients: Cross-linked hyaluronic acid 21mg/g; mepivacaine hydrochloride 3mg/mL
• Strength: 21mg/g HA | 3mg/mL mepivacaine hydrochloride
• Dosage Form: Injectable gel
• Format: 2 × 1mL prefilled syringes (BI-FLEX® syringe system, rebranded from Bi-SOFT®) + 2 × 25 G 40 mm + 2 × 27G½ needles, and 1 × 23G½ needle
• Manufacturer: Laboratories VIVACY
• Brand: STYLAGE®
• Country of Origin: France
• Drug Class: Cross-linked injectable hyaluronic acid dermal filler, supraperiosteal/maximum depth, with mepivacaine
• Regulatory Status: CE-marked for EU use; verify current FDA and local jurisdiction status before use
• Route of Administration: Deep subcutaneous or supraperiosteal injection, depending on treatment area and correction objective
• Storage Requirements: Store below 25°C; do not freeze; protect from direct sunlight
• Intended Use: Experienced licensed aesthetic medicine professionals only

What Is STYLAGE® XXL BI-FLEX® with Mepivacaine?

STYLAGE® XXL BI-FLEX® with Mepivacaine is formulated for extreme facial volume deficits and deep structural contouring that lighter options cannot address. Manufactured by Laboratoires VIVACY (France) and CE-marked for EU use, it utilizes IPN-Like Technology™, which is an interpenetrating network of interlocked HA polymers designed for maximum cohesivity, elasticity, and structural lifting capacity under sustained load. The BI-FLEX® designation marks VIVACY's updated syringe system (rebranded from Bi-SOFT®), engineered to improve ergonomics, injection precision, and structural safety.

Mechanism of Action & Mepivacaine: A Different Anesthetic at Maximum Depth

STYLAGE® XXL BI-FLEX® integrates into deep subcutaneous or supraperiosteal tissue, binding water for immediate structural support. Utilizing IPN-Like Technology™, the gel features high cross-linking density and resistance to mechanical deformation. Like all HA fillers, it is fully reversible with hyaluronidase. The inclusion of mepivacaine hydrochloride (3mg/mL) instead of lidocaine provides specific clinical advantages at maximum depth:

• Faster Onset & Lower Discomfort: Mepivacaine has a more neutral pH profile, closer to the physiological pH of tissue. This minimizes the initial burning sensation and accelerates the onset of anesthesia during deep bolus placement.
• No Vasoconstrictor & Shorter Half-Life: Lacking a vasoconstrictive component and clearing tissue slightly faster than lidocaine, mepivacaine allows for an earlier, unmasked assessment of vascular patency and injection outcomes.

Practitioners must screen patients for hypersensitivity to amide-type local anesthetics and independently review mepivacaine dosage limits. Clinical longevity varies by tissue quality, movement, and lifestyle factors, but typically ranges from 12 to 18+ months due to deep-plane placement.

Indications & Clinical Use

STYLAGE® XXL BI-FLEX® with Mepivacaine injection is appropriate when the volume deficit or structural correction required is beyond what STYLAGE® XL BI-FLEX® or lighter products can achieve. Product selection should be based on the degree of volume loss, condition of the patient's skin, injection plane, and local labeling.

• Extreme volume loss: Severe-to-extreme facial volume deficit in areas such as cheeks, temples, midface, chin, and jawline requiring maximum-depth structural support.
• Maximum-depth structural volumization: Cheekbone augmentation, chin projection, and jawline definition at the supraperiosteal or deep subcutaneous plane.
• Nasolabial folds and marionette lines: Deepest correction layer for folds with an extreme volume-loss component in multi-plane protocols.
• Multi-plane correction: May be combined with lighter STYLAGE® formulations when deep structural support and superficial refinement are both required.
• Experienced aesthetic use: Intended for practitioners with supraperiosteal injection competence, deep-plane anatomical knowledge, and complication management protocols.

Treatment area selection should consider factors such as skin type, age, lifestyle, and the degree of volume loss. Supraperiosteal injection experience is required, given the proximity to neurovascular structures at this depth.

Administration & Safety

STYLAGE® XXL BI-FLEX® with Mepivacaine injection is placed at the deep subcutaneous or supraperiosteal plane. The 25G 40mm needle supports maximum-depth delivery. Technique options include bolus placement, linear threading, or fanning based on practitioner assessment and local labeling; volume per session is at the practitioner's discretion, with overcorrection avoided.

• Pre-treatment assessment: Evaluate medical history, allergies, prior filler use, active infection, pregnancy/lactation status, anticoagulant use, autoimmune history, and vascular risk factors.
• Aseptic technique: Use sterile technique and select the appropriate injection plane.
• Mepivacaine: Co-formulated at 3mg/mL; screen for hypersensitivity to amide-type local anesthetics. Supplemental regional block anesthesia may be used at the practitioner's discretion.
• Post-treatment care: Advise patients to avoid sun exposure, UV light, extreme heat, alcohol, and strenuous activity until redness or swelling resolves.
• Expected local reactions: Bruising at the injection site, redness, swelling, and tenderness may occur and typically resolve within a few days. Deep-plane swelling may be more pronounced and longer-lasting than with superficial formulations.
• Reversal: HA filler may be dissolved with hyaluronidase when clinically indicated.
• Storage: Store below 25°C, protect from direct sunlight, and do not freeze.

Rare but serious risks include vascular occlusion, skin necrosis, visual disturbance or vision loss, infection or abscess formation, granuloma, delayed inflammatory reaction, hypersensitivity, and mepivacaine-related systemic reactions in sensitive patients. Bleeding risk may increase in patients taking anticoagulants, antiplatelet agents, NSAIDs, or supplements affecting coagulation. Refer to the product IFU and local clinical protocols for complete information on contraindications, adverse events, and management.

Availability and Access to STYLAGE® XXL BI-FLEX®

Access to STYLAGE® XXL BI-FLEX® with Mepivacaine should be restricted to licensed healthcare professionals, registered aesthetic clinics, and experienced injectors operating within local regulatory requirements. Professionals evaluating how to buy STYLAGE® XXL BI-FLEX® wholesale should confirm supplier authorization, authenticity documentation, storage conditions, lot number traceability, and jurisdiction-specific regulatory status before procurement. When buying online, product documentation and handling standards should be verified before placing any order. Practitioners who wish to buy dermal fillers or buy STYLAGE® products may contact Doctor Medica's staff for sourcing information and documentation support.

Legal Status of STYLAGE® XXL BI-FLEX® with Mepivacaine

Current as of May 2026, STYLAGE® XXL BI-FLEX® with Mepivacaine is manufactured in France by Laboratories VIVACY and is CE-marked for professional aesthetic use in the EU. Use remains subject to local regulatory requirements, professional scope of practice, and product-specific labeling. Current US FDA status should be verified before procurement or use. FDA approval for dermal fillers is product- and indication-specific, and STYLAGE® XXL BI-FLEX® with Mepivacaine should not be represented as FDA-approved unless confirmed through current FDA databases or official labeling. Practitioners should also verify importation rules and local scope-of-practice requirements before procurement, discussion, or administration.