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Juvederm with a Dental Block Cause More Swelling?

Last year I had Perlane injected in the lines around the nose and mouth. The Dr. numbed the area with ice and proceeded to inject. The pain was horrible and I had terrible bruising for 2 weeks. However, I was pleased with the results. I am going to a different doctor who does a dental block before the injection? Does it really minimize the pain? will there be more swelling after the injections and how many hours does ice need to be applied? Thanks

Doctor Answers (11)

Having Juvederm or Restylane WITH or WITHOUT Nerve Blocks

+2

Having facial fillers (Juvederm,Restylane,Perlane etc) SHOULD be PAINLESS. No one, except the hopelessly uneducated and masochistic among us, should subject themselves to doctors or injectors who still subscribe to the totally unnecessary, outdated and foolish boot camp notion of "no pain - no gain" or "grin and bear it".

There are several reasons why injectors do NOT use nerve blocks. None of them take the patients' interests into account. The Doctors / injectors
do not know facial anatomy to do so - Not a good thing
- do not want to take the time to do so. The practice revolves around a conveyor belt model and slowing the process to increase patient comfort is just not a priority - Not a good thing
- Administering an (infraorbital) nerve blocks costs a few cents more. The time and money are just not worth it - Not a good thing.
- Patients are willing to put up with the pain and return for more.

Giving a patient a dental block (blocking the infraorbital and mental nerves) is painless. It makes the subsequent filler procedures painless and shorter and allows the patient with a hand-held mirror to supervise and participate in the treatment.

Save the ice for an adult beverage. There is NO REASON why anyone should subject themselves to ANY painful filler injections these days.


Memphis Plastic Surgeon
5.0 out of 5 stars 62 reviews

Dental blocks eliminate pain of injecting Restylane and Juvederm.

+2

Hi.

Dental blocks are the way to go.  The doctor just has to know the anatomy. Blocks do not cause extra swelling.  Because the patient is relaxed and quiet, I can take my time with Restylane or Juvederm, and do the best possible sculpturing job.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Dental blocks and fillers

+1

I am not a big fan of the dental blocks it can distort treatment areas.  Usually topicals do the trick and I use lidocaine in the products.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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Injection of Juvederm with a dental block is great, but try Juvederm XC with lidocaine in it.

+1

Injection of fillers like Juvederm can be done in the office under local anesthesia such as topical, direct injections and/or blocks. These all are combined with ice to limit swelling and bruising. Juvederm does have a new filler called Juvederm XC with powdered lidocaine in it and in both forms: Juvederm XC Ultra and Ultra plus. Dental blocks are great for injection in and around the lips and will make things very comfortable. They should limit the swelling and bruising in the area secondary to the lack of pre-injection trauma and the increased comfort level. Since you had such a bad experience last time I would try the injections with a block and then graduate to the XC for the nasolabial folds. Still use ice, but this will be a better and more accurate placement of the filler.

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.5 out of 5 stars 11 reviews

Dental blocks for fillers

+1

Dental blocks do not cause significant swelling in the locations they are injected. They can make the procedure of filling the smile folds and marionette lines painless.  If the lips are to be injected, then a local block can be done in the lips under the mucosal lining which blocks the middle of the lip which sometimes is not numbed by the dental blocks.

There are many patients though, that do not want dental blocks because they don't like the feeling of the droopy lips as if they were just at the dentist. Without these blocks, the following can be used: Ice before hand, a good numbing cream, mixing the filler with an anesthetic (which is becoming very common) and a slow delivery of the injeciton all make the procedure very tolerable.

Ronald Shelton, MD
Manhattan Dermatologist
5.0 out of 5 stars 31 reviews

Juvederm, Resytlane, Perlane injectable Pain and Discomfort well managed

+1

The art and skill of injecting facial injectables, such as Juvederm, Restylane and Perlane, Sculptra and Radiesse require the physician to be adept at the art of minimizing pain and discomfort. It is realistic as a patient to expect some degree of pain and discomfort, but the use of local anesthesia to "block" the areas to be injected can minimize the discomfort. Other strategies deployed by doctors to reduce pain include topical anesthetic gels, and forced cooling air systems.

Fortunately, all the commonly used injectables, Juvederm and Restylane will soon come with local freezing already mixed in with the Gel and these products "numb and freeze' the area as they injection occurs.

Using any type of local anesthetic to "freeze" an area does not in general increase post injection swelling and bruising.

Of course, you should always consult a skilled, experienced and certified physician specialist in aesthetic medicine before embarking upon any treatment advice or program.

R. Stephen Mulholland, MD
Toronto Plastic Surgeon
4.5 out of 5 stars 20 reviews

Perlane

+1

Fillers can be injected with dental blocks. however every time you insert a needle whether for block or filler you run the risk for a bruise.

At the very end you need to be comfortable and accept the potential for risks and complications for any invasive procedure. You are changing your physician because of bruising, is the new Dr. quaranteeing no bruise/ no swelling?

There are many unqualified physicians doing injections of Botox and fillers including primary care, gynecologists, emergency room physicians, family physicians, ophthalmologists all with very little knowledge of the anatomy of the face.

Samir Shureih, MD
Baltimore Plastic Surgeon

Nerve blocks for Juvederm injections should not affect swelling

+1

Nerve blocks should not increase your swelling.  They might increase the risk of bruising however, as each nerve block injection has the potential for causing a bruise.  Your physician will advise you on how long he/she would like you to apply ice after your treatment, but usually intermittently for several hours or throughout that first day is sufficient.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
5.0 out of 5 stars 167 reviews

Juvederm can be injected very comfortably without dental block

+1

Juvederm, particulary the new XC version which contains factory added lidocaine can be injected rather painlessly with just topical and no dental block.  I feel the dental block adds more pain and can lead to swelling which makes the correction harder to do (don't know what is caused by the block and what was there before).  I ask my patients to apply ice for about 1-2 hours, but to be careful because you will be numb and don't want to create a problem by freezing the skin.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Block is the way to go

+1

We find a block makes filler injections  - juvederm, radiesse, or natural fat transfers very easy around the lips and nose.  It should not cause any extra swelling: but just like going to the dentist, you may have the sensation your face is swollen for a couple of hours. That would be more of a personal feeling than an outward appearance though. Application of ice will depend on several factors and would best be asked of your own doctor. 

Best wishes for a great result.

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.