Pre-Treatment with Antihistamines in Aesthetic Soft Tissue Facial Augmentation

Purpose:  Aesthetic soft tissue facial augmentation using neuromodulators and dermal fillers has become ubiquitous in the United States, accounting for over 8 million minimally invasive procedures performed in 2013¹.  Despite high rates of satisfaction², these facial rejuvenation procedures are not without complications, including pain, edema and erythema post-treatment_³.  We present a pre-treatment regimen using both topical and oral antihistamines that decrease edema, erythema and pain.

Methods & Materials: Long-term patients of a single plastic surgeon were instructed to take a second-generation antihistamine prior to injection of dermal filler or botulinum toxin injection.  A topical cream containing benzocaine 20%, lidocaine 6%, tetracaine 4% (BLT) with special formulation including diphenhydramine 2% was applied topically to areas being treated 30 minutes prior to injection.  Patients reported subjective findings regarding facial edema and redness following the procedure and within 3 days post-treatment.

Results:   All patients reported subjective improvement in both facial edema and erythema when compared to past experiences.

Conclusions:  Pre-treatment with oral and topical antihistamines prior to minimally invasive aesthetic soft tissue facial augmentation improves edema and erythema and should be considered in any patient undergoing treatment.