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Is Juvederm for Lips 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?

Doctor Answers 39

Have your doctor mix Lidocaine with Juvederm

That must have been really painful to faint like that.

Make sure the physician leaves the topical anesthetic on 30-40 minutes. Perhaps, after your experience, the doctor has found another pharmacy to mix up his anesthetic formulation. We have found our topical to be wonderful, after trying two others (one including Pliaglis).

I find Morita's Hurricaine sticks to be helpful under the lip and in the area for the dental block. Then the dental block should be performed knocking out the infraorbital and mental nerves.

Agree with the adding Lidocaine to the filler helps and slow injection techniques.
Not that I agree with this but some physicians, prefer not to do a dental block. They feel that the dental block can distort the lips.

Using the above measures should make lip augmentation much less of a harrowing event for you.


Virginia Beach Dermatologist
4.5 out of 5 stars 13 reviews

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

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.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 63 reviews

Juvederm placed in the lips can be painful if no local...

Juvederm placed in the lips can be painful if no local or topical is used. Some of my patients take it "cold" - no anesthetics. Most take at least a topical.

For the more sensitive patients, I will often place a topical on the skin for 30 minutes, and add a viscous lidocaine solution to be placed along the gum line inside the mouth for about 5-10 minutes prior to performing nerve blocks. This makes the lip completely anesthetic and very easy for the patient.

I am sure you were just very nervous, and that is why you fainted. My patients often comment on how easy the procedure went.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

No need to have any pain

Juvederm to the lips are painful if you do not get adequate anesthesia.

I usually do nerve block (like the dentists use) to numb the lips. Once the lip is completely numb, I do the injection.

Next time, ask for nerve block.

Payman Simoni, MD
Beverly Hills Facial Plastic Surgeon
4.0 out of 5 stars 10 reviews

Pain with lips injections

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.

Juvederm Injections: Pain Tolerance Varies

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.

Discomfort from Juvederm injected into lips.

Thanks for your question. It sounds like you had a tough experience. 

That being said, you should know that you can still have lip injections! The most important aspect is managing your expectations and doing it in a controlled setting. I'd recommend going to someone who will take their time with you and explain the procedure calmly. In the past, a lot of doctors used a "Dental Block" but now, we typically use numbing cream and let it sit on your lips for a good 30 minutes or so. Also, we can use Juvederm that has lidocaine in it, so it isn't as uncomfortable going in, and it is numb afterwards. 

For people that pass out easily, it will help if you are in a relaxed setting and in a reclined chair. It might be helpful to drink some orange juice before hand, so you are not low on sugar. Also, I find that instructing patients to take long - slow - deep breaths in and out helps tremendously. 

Good Luck!

Dan Landmann, MD
Ridgewood Ophthalmologist
5.0 out of 5 stars 23 reviews

Juvederm without nerve blocks every time

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.

Lip Injections and Pain

Lip injections are a very easy and quick procedure.  The key is to applying a good topical numbing cream over an hour before the injections.  I use a special numbing cream that I use on patients for Fraxel laser.  It is the "Chanel" of numbing cream.  The procedure is easily tolerated after you have the topical numbing medicine for one hour.  For the best cosmetic results please consult a board certified dermatologist with a great deal of experience with fillers and lasers.

Juvederm Post-Care

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.

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.