Hi Kaylan: in the US, this guidance comes from the CDC and unfortunately it doesn't give exact information. The recommendation is as follows: From an infection control perspective, the safest practice is to prepare an injection as close as possible to the time of administration to the patient. This is to prevent compromised sterility (i.e., microbial contamination or proliferation) or compromised physical and chemical stability (e.g., loss of potency, adsorption to the container) of the medication when it's transferred outside of its original container and stored for a period of time before administration.
Hello! Thank you for your question. Normal Saline (0.9%) and lidocaine are often used to "thin" a dermal filler. Neither changes the structure of the filler, but when added they allow for different extrusion properties - and in the case of lidocaine - anesthetic properties. Saline and lidocaine are preferable to water as a diluent - since they both contain "salt" (hydrochloride). Blood cells also contain "salt" but sterile water does not. Therefore, lidocaine and normal saline are both considered closer in tonicity to plasma than water. Since water is considered hypotonic, it's presence - once injected - would cause the local blood cells to want to absorb the local water. This would cause the blood cells to swell and ultimately burst. - not a desired effect. I hope that helps! Again, thank you for your question!
Thank you very much for thus informative video,I have one question in my aria we have two kind of lidocaine one is 2% lidocaine solution and another one is 2% lidocaine with bicarbonate , which one shall I use for mixing and can I use lidocaine mixed with epinephrine solution adding lip fillers?
Hi Sara - thanks for the question! Most practitioners use either 1% or 2% Lidocaine (with or without epinephrine). There's very little in the literature surrounding addition of bicarb to lidocaine as it relates to facial injectables. However, in treatment unrelated to facial injectables, the literature does indicate that buffering lidocaine with bicarb decreases epinephrine activity by 25% per week. So if you do choose to buffer, the recommendation is to use the compounded anesthetic within 1 to 2 weeks after preparation. I hope that helps. Thank you for watching!
Hi Jeremy: thank you for your question - I find the best approach is to divide the total sum in half - (each syringe should have approximately 0.6cc if you started with 1cc of product). So, you'll be using both syringes. The advantage to doing this is: when trying to achieve symmetry, knowing how much each side of the face has received is helpful. Especially when you begin with the more deficient side---Having equal amounts in each syringe is an automatic reminder when you've used half and have half the amount remaining. I hope that makes sense. Thanks again for your question.
Hi Jeremy - back-filling any syringe breaks the line of asepsis, so, not a good idea. Here's a link to my video explaining that: th-cam.com/video/C2N4ajsmuOI/w-d-xo.html Thanks so much for the good questions!!! Stay well.
![CAN SALINE REVERSE FILLER? Is saline an alternative to hyaluronidase? [Aesthetics Mastery Show]](/img/n.gif)
Excellent presentation and clearly explained the technique. Thank you for explaining the differences in syringes and details of the technique!
Can you mix saline to make fillers softer. If so is it 50/50 solution amounts?
Great video. Just what i was looking for. Thanks
Excellent clear and nice presentation.
Glad it was helpful!
Thank you sir
Thank you because I only use radiesse for the calcium to offset my osteoporosis
Excellent video...
Thank you! Let us know if there's something else you'd like us to cover!
After mixing the lidocaine into the filler, how long is the mixture safe to use before it is considered expired ?
Hi Kaylan: in the US, this guidance comes from the CDC and unfortunately it doesn't give exact information. The recommendation is as follows: From an infection control perspective, the safest practice is to prepare an injection as close as possible to the time of administration to the patient. This is to prevent compromised sterility (i.e., microbial contamination or proliferation) or compromised physical and chemical stability (e.g., loss of potency, adsorption to the container) of the medication when it's transferred outside of its original container and stored for a period of time before administration.
So pointed ❤
Thanks so much for taking the time to comment!!
Nice explanation 👏🏻
Thank you 👍🏻
Nice explanation👍👍👍
Does saline changes the structure of filler? Sterile water or saline which is better? Plus why we add lidocaine to thin down filler?
Hello! Thank you for your question. Normal Saline (0.9%) and lidocaine are often used to "thin" a dermal filler. Neither changes the structure of the filler, but when added they allow for different extrusion properties - and in the case of lidocaine - anesthetic properties. Saline and lidocaine are preferable to water as a diluent - since they both contain "salt" (hydrochloride). Blood cells also contain "salt" but sterile water does not. Therefore, lidocaine and normal saline are both considered closer in tonicity to plasma than water. Since water is considered hypotonic, it's presence - once injected - would cause the local blood cells to want to absorb the local water. This would cause the blood cells to swell and ultimately burst. - not a desired effect. I hope that helps! Again, thank you for your question!
@@facesdoctor thank you very much
Thank you very much for thus informative video,I have one question in my aria we have two kind of lidocaine one is 2% lidocaine solution and another one is 2% lidocaine with bicarbonate , which one shall I use for mixing and can I use lidocaine mixed with epinephrine solution adding lip fillers?
Hi Sara - thanks for the question! Most practitioners use either 1% or 2% Lidocaine (with or without epinephrine). There's very little in the literature surrounding addition of bicarb to lidocaine as it relates to facial injectables. However, in treatment unrelated to facial injectables, the literature does indicate that buffering lidocaine with bicarb decreases epinephrine activity by 25% per week. So if you do choose to buffer, the recommendation is to use the compounded anesthetic within 1 to 2 weeks after preparation. I hope that helps. Thank you for watching!
@@facesdoctor Thank you very much
I know you said 2/10th of lido is it the same with saline?
Hello - yes, on average 2/10ths works well without over-diluting or creating a "false-fill" phenomenon,. Thanks for the question!!
Do you inject the filler from the syringe with the original 0.2cc of lido or you transfer that into the manufactures 1cc filler syringe? ty
Hi Jeremy: thank you for your question - I find the best approach is to divide the total sum in half - (each syringe should have approximately 0.6cc if you started with 1cc of product). So, you'll be using both syringes. The advantage to doing this is: when trying to achieve symmetry, knowing how much each side of the face has received is helpful. Especially when you begin with the more deficient side---Having equal amounts in each syringe is an automatic reminder when you've used half and have half the amount remaining. I hope that makes sense. Thanks again for your question.
@@facesdoctor That was well explained, thank you. What are your brief thoughts about backloading filler into an insulin syringe? Ty
Hi Jeremy - back-filling any syringe breaks the line of asepsis, so, not a good idea. Here's a link to my video explaining that: th-cam.com/video/C2N4ajsmuOI/w-d-xo.html
Thanks so much for the good questions!!! Stay well.