Tumescent anesthesia for reducing pain, swelling, and ecchymosis during polycaprolactone filler injections in the face.

PCL filler can be injected in two major ways to control pain. One such method involves mixing 0.3cc of PCL filler with lidocaine, and the other is the method introduced in this report, which involves pre-injection with a tumescent solution. It is hard to reduce pain effectively with pre-mixing PCL filler with lidocaine because there may be not enough time to act lidocaine solution effect immediately for pain control. The pre-mixing method changes the properties of the original filler, especially the property of the CMC portion. Therefore, in my simple and novel technique, tumescent solution is injected, followed by PCL filler which preserves the original CMC property. This is done after sedation of the tissue by the tumescent solution and dissection of soft tissue to create a space for the ensuing PCL injection. After pre-injection with tumescent solution, histological analysis indicated that the tissue did not become irritated in response to the foreign body material (PCL filler) or the mechanical trauma caused by the needle. That is the key mechanism of the tumescent injection method for reducing tissue reaction and that may reduce pain and swelling during and after PCL filler injections.