Anesthesia with Lip Augmentation: Juvederm, Restylane. Towards painless lip augmentation

Raffy Karamanoukian, MD answers: Is Juvederm painful?

I went a couple days ago to get my lips plumped up with Juvederm. The MD applied a topical anesthetic and then proceded to give a local one like you get in your gums at the dentist. It was so painful that I fainted. I didn't even get to have my lips done. I'm too scared to go back and finish the procedure but I paid a lot of money. Is there any way this can be completed with out me having to pass out from the pain? Should lip injections hurt this bad?


Raffy Karamanoukian, MD
11 months ago

Lip Augmentation with facial fillers such as Juvederm and Restylane is a very common procedure. Although pain tolerance between patients varies considerably, there are many topical, injection technique related, and infiltrative anesthetic treatments that can minimize pain.

A reasonable approach to anesthesia for lip augmentation should focus on the following techniques:

  • Local anesthetic block of the infraorbital nerve and mental nerves
  • Topical anesthesia of the inner lip mucosa and the outer lip skin
  • Bolus injections of lidocaine into the upper sulcus and lower sulcus to reduce any ancillary nerve fibers
  • Use of a smaller needle.

If you are still having pain after the first injection, have your practitioner apply more topical anesthetic and injection.  Be aware that anesthetics have toxic doses and only an experienced medical physician should be injecting these medicines.

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