Is Juvederm for Lips Painful?

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.

It is very important to completely numb the lips before injection.  Unfortunately, you can't inject directly into the lips without distorting the shape and risking the final result.  I use a topical anesthesia and then do a dental block (numbing the nerve before it arrives in the lips).  If you use vibration, distraction and precise and proper technique, you can do the dental block with minimal to no pain.  Once the lips are numb you should be able to do whatever you want to the lips and shouldn't feel a thing.

Thank you for your question!  I would reccomend a topical numbing cream before the actual injections.  Everyone is different when it comes to pain tolerance.  Best of luck!Dr Dhaval PatelDouble Board Certified Plastic SurgeonChicago Hoffman EstatesOak Brook

Thanks for this question.Thats sounds like a very difficult experience for you.Its hard to know why you fainted. That may not be the actual pain, but more the thought of, or the actual viewing of the needle.There are many good options for pain control during lip injections. Topical anaesthetic is great and so is ice. These can be used together and don't involve any needles. You may wish to try this and also try not to look at the needle on the syrige when your Doctor is working on your lips.

Lip injections do tend to be among the most uncomfortable of the dermal injections. I often use topical numbing medication combined with ice. Injectable filler agents also have lidocaine built into them and this also makes the procedure more comfortable. The vast majority of patients tolerate this fairly well. For those that need additional numbing, I will do dental blocks.

Pain tolerance varies from patient to patient when
injectable fillers are used. In some cases, patients are able to undergo the
procedure without anesthesia, while in other patients, anesthesia is an
absolute requirement.The
lips have a high density of sensory nerves and for this reason are very
sensitive to pain. Pain thresholds vary from patient to patient for a variety
of reasons including anxiety. In some patients this procedure can be performed
without anesthesia; while in others this would never be a consideration. Based
on your history, quality anesthesia was never really attained and as a result
the procedure was discontinued. Clearly
alternate strategies are necessary to make this a comfortable experience. Multiple options are available for anesthesia
under these circumstances. These include topical agents, injectable agents and
drugs that address anxiety. In many cases slowing down the process and using
these tools in combination can make this a more comfortable experience.Topical
anesthetics are relatively easy to use. These agents are simply spread over the
area before the procedure. They take approximately 10 to 15 minutes to work and
are moderately effective. The administration of these agents is pain free, but
doesn’t totally alleviate pain from the injection of dermal fillers. They can
also be used intra orally prior to intraoral anesthetic injections. When
using injectable fillers nerve blocks with local anesthetics are extremely
effective. This procedure is performed by infiltrating local anesthetic
intra-orally in the area of the infra orbital and mental nerves. This
effectively provides anesthesia of the upper and lower lips and surrounding
areas. This approach provides excellent
anesthesia which is almost instantaneous.Treating
anxiety with Valium is also helpful when these situations arise. Using topical anesthetics prior to injections
and giving these drugs adequate time to work is important as well. When injecting local anesthetics, it’s important
to inject slowly to avoid unnecessary pain. When these steps are taken treatment with injectable fillers can be a
much more comfortable experience for patients.

The Juvederm Ultra Plus XC has powdered lidocaine in the product premixed.  It is possible to inject this material in the lips without topical anesthetics and certainly without nerve blocks.  Restylane injections previous all required these nerve blocks.  Newer techniques, newer products, smiled injectors, less pain.  Make sure that the person injecting the Juvederm is a board certified plastic surgeon. Nurse injectors just do not have enough skill, training, education, or expertise to inject fillers.

I am sorry to hear this happened to you.
Generally, topical anesthetic and ice applied prior to the treatment is enough
to help minimize your discomfort. Some physicians use the anesthetic injection
you described, but I do not believe this is necessary for pain control, as
topical anesthetics and ice are usually enough. I would advise that you try
again, only using topical anesthetics
and ice.

Lips and fingertips are very sensitive areas.  We routinely give topical numbing as well as a dental block for placing filler in the lip.  The injections are usually well tolerated.  Many injectable materials now have lidocaine, (a numbing medicine), in the syringe itself. (Juvederm Ultra and Ultra Plus XC, Restylane L).  This helps, but we still do the topical and the block.

Lip injections can really hurt.  I used to use nerve blocks pretty regularly for this, but since Juvederm XC came onto the market, I haven't done one since.  My patients love it, and we use a 2-step process to make all types of facial injections virtually pain free:

1) Topical numbing cream.  This makes the needle insertion painless.  

2) Juvederm XC.  Once the needle is in, the lidocaine in the XC formulas make the injection virtually pain free.

I recommend ice as needed to patients, although they rarely do need it.  The nice thing about staying away from nerve blocks is that they offer their own set of complications, and, as you experienced, can be painful to get in the first place.  Further, they can sometimes alter the shape of the mouth so that the injector is not working on a normal "canvas".

We do a lot of lip augmentations and pain is very limited due to a variety of factors. We do a dental block with possible topical anesthetic when necessary depending on patient preference. We inject slow and use the smallest needle possible, along with soft music to limit discomfort. Patients always come back for more.