Stylage L Bi-Soft

Stylage L Bi-Soft is a premium, high-density hyaluronic acid-based dermal filler designed for deep facial volume restoration and structural contouring. Part of Vivacy Laboratories’ advanced Stylage range, this product features enhanced IPN-Like technology optimized for significant volumetric correction and long-lasting structural support.

Key Product Specifications

Active Ingredient: Cross-linked Hyaluronic Acid (24 mg/ml)
Volume: 1.0 ml pre-filled syringe
Needle: 25G1″ needle included
Particle Size: Large (optimized for deep dermal/subcutaneous injection)
Viscosity: High viscosity for maximum lift and projection
pH: Physiological (approximately 7.0)
Osmolality: Isotonic with human tissues
G’ (Elastic Modulus): High – superior structural support

Clinical Indications

Primary Indications:

• Deep nasolabial fold correction
• Severe marionette lines treatment
• Cheek volume restoration and contouring
• Chin augmentation and projection
• Jawline definition and enhancement
• Temple volume restoration
• Non-surgical rhinoplasty (advanced practitioners)

Treatment Areas:

• Deep facial volume loss correction
• Structural facial contouring
• Age-related volume depletion
• Facial asymmetry correction
• Lower face and jawline sculpting
• Mid-face lifting and support

Injection Technique Guidelines

Injection Depth: Deep dermis to subcutaneous layer
Injection Technique: Linear threading, depot technique, or fanning method
Flow Rate: Requires controlled pressure due to high viscosity
Recommended Volume per Site: 0.2-1.0 ml depending on treatment area
Cannula Compatible: 22G or 25G blunt-tip cannulas recommended for large volume areas

Expected Results & Duration

Onset: Immediate structural improvement
Peak Effect: 4-6 weeks post-treatment
Duration: 15-24 months (individual variation applies)
Touch-up: Typically required at 9-12 months for maintenance
Longevity Factors: Higher cross-linking density provides extended duration

Contraindications

Absolute Contraindications:

• Known hypersensitivity to hyaluronic acid or lidocaine
• Active skin infection or inflammation at treatment site
• Severe autoimmune disorders
• Pregnancy and breastfeeding
• History of severe allergic reactions
• Patients under 21 years of age (due to structural nature)
• Active oral herpes (for perioral treatments)

Relative Contraindications:

• Bleeding disorders or anticoagulant therapy
• History of keloid or hypertrophic scarring
• Unrealistic patient expectations
• Recent facial surgery (within 4 weeks)
• Immunocompromised patients
• Previous adverse reactions to HA fillers

Side Effects & Complications

Common (Expected) Reactions:

• Moderate erythema (24-72 hours)
• Localized swelling (3-10 days, can be pronounced)
• Bruising at injection sites
• Temporary firmness or palpability
• Initial overcorrection appearance
• Mild asymmetry during settling period

Rare but Serious Complications:

• Vascular occlusion/compromise
• Granulomatous reactions
• Biofilm formation
• Product migration
• Persistent nodules or lumps
• Tyndall effect (if injected too superficially)
• Late-onset inflammatory reactions

Pre-Treatment Protocol

Patient Assessment:

• Comprehensive facial analysis and volume assessment
• Detailed medical history including previous filler treatments
• Allergy screening (HA products, lidocaine, gram-positive bacteria)
• 3D facial photography for documentation
• Realistic expectation management and counseling
• Detailed informed consent process

Pre-Treatment Instructions:

• Discontinue anticoagulants if medically appropriate (10-14 days)
• Avoid anti-inflammatory medications 1 week prior
• No alcohol 48 hours before treatment
• Consider prophylactic antiviral therapy for perioral treatments
• Postpone if any signs of infection or inflammation

Post-Treatment Care Instructions

Immediate Care (First 48 hours):

• Apply cold compress 10-15 minutes every hour while awake
• Sleep with head significantly elevated (2-3 pillows)
• Avoid touching, pressing, or massaging treated areas
• No strenuous exercise or activities causing facial flushing
• Avoid alcohol consumption

Week 1-2 Post-Treatment:

• Gentle skincare routine with mild, non-irritating products
• Avoid extreme temperatures (saunas, hot yoga, steam rooms)
• No facial treatments or aggressive skincare procedures
• Use broad-spectrum SPF 30+ daily
• Avoid dental procedures if lower face was treated
• Sleep on back if possible to prevent pressure on treated areas

Ongoing Care:

• Regular follow-up appointments at 2 weeks, 1 month, and 6 months
• Professional assessment of settling and integration
• Touch-up planning if necessary

Storage & Handling

Storage Temperature: 2-25°C (36-77°F)
Storage Environment: Original packaging, protected from light
Shelf Life: 24 months from manufacture date
Freezing: Strictly prohibited – destroys product integrity
Sterilization: Pre-sterilized, single-use only
Handling: Allow to reach room temperature before injection for optimal flow

Pricing & Practice Integration

Investment Considerations:

• Premium pricing tier due to advanced technology and longevity
• Higher initial cost offset by extended duration (15-24 months)
• Typically requires 1-2 syringes for comprehensive treatment
• Excellent return on investment due to patient satisfaction
• Reduced need for frequent touch-ups

Practice Benefits:

• Positions practice as offering advanced aesthetic solutions
• High patient satisfaction and referral rates
• Predictable, reproducible results
• Lower complication rates with proper technique
• Strong brand recognition and clinical reputation

Patient Selection Criteria

Ideal Candidates:

• Ages 30-70 with significant volume loss
• Realistic expectations about treatment process
• Commitment to follow-up care and maintenance
• Good general health status
• Understanding of investment required
• Previous positive experience with dermal fillers

Suboptimal Candidates:

• Patients seeking subtle enhancement only
• Those with unrealistic timeline expectations
• Poor compliance with post-treatment instructions
• History of multiple filler complications
• Excessive movement or facial expressions during treatment
• Budget constraints for proper maintenance

Advanced Technique Considerations

Cannula Technique Benefits:

• Reduced bruising and swelling
• More comfortable patient experience
• Better product distribution in large areas
• Lower risk of vascular complications
• Ideal for temple and cheek treatments

Layering Approach:

• Deep structural support with Stylage L Bi-Soft
• Superficial refinement with lighter HA products
• Optimal natural-looking results
• Comprehensive facial rejuvenation

Frequently Asked Questions for Providers

How does L Bi-Soft differ from regular Stylage L?
L Bi-Soft features enhanced cross-linking technology providing improved tissue integration, reduced inflammatory response, and potentially longer duration.

Can this be used for non-surgical rhinoplasty?
Yes, but only by experienced practitioners due to high-risk vascular anatomy. Requires advanced training and emergency protocols.

What’s the recommended injection speed?
Slow, controlled injection (approximately 0.1ml per 5-10 seconds) to ensure proper placement and minimize tissue trauma.

How long before patients can return to normal activities?
Light activities after 24-48 hours, full activities after 1 week, with final results assessed at 4-6 weeks.

Is this suitable for first-time filler patients?
Generally recommended for patients with previous filler experience due to the significant swelling and longer settling period.

Combination Therapy Protocols

With Botulinum Toxin:

• Perform filler treatment first
• Wait 2 weeks before botulinum toxin injection
• Allows proper assessment of filler results
• Minimizes bruising risk

With Other Aesthetic Procedures:

• Space treatments 4-6 weeks apart
• Consider cumulative swelling effects
• Plan sequence based on healing requirements
• Coordinate with other practitioners as needed

Emergency Management Protocols

Vascular Compromise Management:

1. Immediate Response:
   • Stop injection immediately
   • Assess circulation and skin color
   • Apply warm compress to increase blood flow
2. Medical Intervention:
   • Inject hyaluronidase 150-500 units immediately
   • Administer aspirin 325mg if not contraindicated
   • Apply nitroglycerin paste 2% to affected area
   • Consider hyperbaric oxygen therapy consultation
3. Follow-up Care:
   • Document thoroughly with photographs
   • Arrange immediate specialist referral if needed
   • Close monitoring for 24-48 hours
   • Patient education about warning signs

Infection Management:

• Culture if purulent drainage present
• Broad-spectrum antibiotic therapy
• Consider hyaluronidase dissolution
• Close follow-up until resolution

Quality Assurance & Documentation

Treatment Documentation:

• Pre-treatment photographs (multiple angles)
• Product lot numbers and expiration dates
• Injection sites, depths, and volumes used
• Patient response and immediate post-treatment appearance
• Post-treatment care instructions provided
• Follow-up appointment scheduling