Product Specifications
- Active Ingredient: Hyaluronic acid (cross-linked) 21mg/g; Mepivacaine Hydrochloride 3mg/mL
- Regulatory Status: CE-marked (EU); practitioners should verify current US FDA status and other applicable jurisdictions independently
- Molecular Type: Cross-linked hyaluronic acid (IPN-Like Technology™) with mepivacaine hydrochloride
- Strength: 21mg/g HA | 3mg/mL Mepivacaine Hydrochloride
- Dosage Form: Injectable gel. Comes in 2 × 1mL prefilled syringes (BI-FLEX® syringe system) + 2 × 25G 40mm needles (supraperiosteal/deep injection) + 2 × 30G ½ needles (superficial injection/cleanup)
- Manufacturer: Laboratories VIVACY
- Brand: STYLAGE®
- Country of Origin: France
- Storage Requirements: Store below 25°C; do not freeze; protect from direct sunlight
- Intended Use: Extreme volume loss, maximum-depth facial volumization, and structural contouring — for experienced licensed aesthetic professionals with supraperiosteal injection competence
Who Is STYLAGE® XXL BI-FLEX® with Mepivacaine Indicated For, and When Should Practitioners Choose It?
STYLAGE® XXL BI-FLEX® with Mepivacaine is designed for experienced aesthetic professionals treating patients with severe-to-extreme facial volume loss. Common treatment areas are where substantial structural support is required, including:
- Cheeks
- Temples
- Jawline
- Chin
- Midface
The product may also contribute to the deepest correction layer of complex protocols addressing nasolabial folds and marionette lines when volume deficiency is a significant component.
Patient suitability should account for the condition of the patient’s skin and underlying tissue support, individual treatment objectives, facial anatomy, factors such as skin type and lifestyle, and practitioner experience with supraperiosteal and deep subcutaneous injection techniques.
Because this product is intended for the deepest injection planes, practitioners should possess advanced knowledge of facial anatomy and strict aseptic technique, and must avoid intravascular injection.
When to Choose STYLAGE® XXL
STYLAGE® XXL BI-FLEX® with Mepivacaine occupies the most structural position within the STYLAGE® range. It is typically selected when STYLAGE® XL cannot provide sufficient projection, contouring, or lifting capacity. STYLAGE® L and M are generally used for moderate correction, and STYLAGE® S or lip-specific formulations are better suited to superficial wrinkles and perioral enhancement.
The transition from Bi-SOFT® to BI-FLEX® introduces improved ergonomics, precision, and safety. These benefits are particularly valuable during deep structural injections.
STYLAGE® products are CE-marked for professional use in applicable European markets; practitioners should verify current regulatory standing in their jurisdiction before clinical use. STYLAGE® XXL BI-FLEX® is a robust STYLAGE® dermal filler option within the range for complex volume restoration cases requiring maximum-depth structural support.
How Does STYLAGE® XXL BI-FLEX® with Mepivacaine Work, and What Is the Clinical Role of Mepivacaine at XXL Depth?
At 21mg/g, the cross-linked hyaluronic acid gel integrates into deep facial tissues and attracts water molecules, providing immediate structural support and helping restore volume in areas such as the cheeks, chin, temples, and jawline. IPN-Like Technology™ interlocks hyaluronic acid chains into a cohesive yet moldable network that maintains contour under facial movement in high-stress regions.
Results vary depending on factors such as skin type, treatment area, lifestyle, and injection technique; structural hyaluronic acid volumizers are generally discussed in the 12–18 month range before significant retreatment. The product is fully reversible through hyaluronidase administration when correction or reversal is clinically required.
A defining clinical distinction of STYLAGE® XXL BI-FLEX® with Mepivacaine injection is its use of mepivacaine rather than lidocaine as the co-formulated anesthetic. Research comparing the two agents in hyaluronic acid fillers indicates that mepivacaine exhibits lower vasodilatory activity than lidocaine at clinically relevant concentrations, which may reduce bruising at the injection site and some vascular-related side effects associated with deep-plane injection.
Mepivacaine also offers a rapid onset and a favorable pH for injection comfort. Its somewhat shorter anesthetic duration compared to lidocaine allows earlier assessment of structural outcomes once numbness resolves. This is a practical advantage during supraperiosteal procedures where immediate volume evaluation guides correction decisions.
How Is STYLAGE® XXL BI-FLEX® with Mepivacaine Administered, and What Are the Safety Considerations?
STYLAGE® XXL BI-FLEX® with Mepivacaine is intended for supraperiosteal or deep subcutaneous placement by experienced practitioners.
The supplied 25G 40mm needle supports precise product delivery at the intended anatomical depth using a slow, low-pressure technique; aspiration, where feasible, further reduces vascular risk. The co-formulated 3mg/mL mepivacaine provides procedural analgesia; supplemental regional anesthesia may be used at the practitioner’s discretion in extensive or sensitive treatment plans.
Following treatment, patients should avoid excessive sun exposure, heat, and strenuous exercise until redness and swelling resolve. Because this product is designed for deep volumization, post-treatment swelling may be more pronounced and longer-lasting than with superficial injectable dermal fillers; patients should be counseled accordingly.
Common and Serious Side Effects
Most treatment-related reactions are mild and transient, including:
- Redness
- Swelling
- Tenderness
- Bruising at the injection site
- Temporary discomfort
These effects generally resolve within a few days, although deep-plane swelling may persist longer than with more superficial injectable dermal fillers.
Although uncommon, serious complications may include vascular occlusion, skin necrosis, visual disturbances, and severe inflammatory reactions. Practitioners must be trained to recognize these events and follow emergency management protocols before performing treatment. Patients should be screened for hypersensitivity to hyaluronic acid or amide-type anesthetics, including mepivacaine, before treatment.
Full safety information should be reviewed in the manufacturer’s Instructions for Use (IFU).
What Is the Regulatory Status of STYLAGE® XXL BI-FLEX® with Mepivacaine?
STYLAGE® XXL BI-FLEX® with Mepivacaine is manufactured in France by Laboratories VIVACY and carries CE marking for professional aesthetic use within applicable jurisdictions. The product is intended exclusively for licensed medical professionals and qualified aesthetic practitioners. Regulatory classifications may differ across countries, and practitioners should verify current approval, importation, distribution, and professional-use requirements within their jurisdiction before procurement or clinical use.
Practitioners who wish to buy dermal fillers or buy STYLAGE® may contact Medical Spa Rx’s professional support team for sourcing information and documentation support. Practitioners evaluating wholesale options for STYLAGE® XXL BI-FLEX® should confirm that suppliers comply with applicable storage, transport, and regulatory standards. When buying online, practitioners should ensure that products originate from legitimate, properly authorized sources. Regulatory information is current as of mid 2026; local verification is essential before purchase or treatment. For sourcing guidance, contact Medical Spa Rx’s professional support team.
