The vaginal canal portion of the FemiLift and MonaLisa treatments requires no anesthesia. However, if you are asking about the outer skin - perineum or labia majora, then a topical anesthetic cream will take adequate effect in 10 minutes. I find it more effective and much faster to inject local anesthesia using a microneedle and syringe.
The internal laser MLT treatments are pain free and do not require any analgesia. For the external treatments, the EMLA cream may take as long as 15 minutes. I have found that BLT cream is much quicker and usually is fully effective within 5 minutes.
No need for anesthetic cream when performing intra-vaginal fractional CO2 laser. If you will be having EXTERNAL work (on the outside of your vagina,) then Emla or "BLT" cream should be applied 1-2 hours prior to the procedure and covered with a plastic film ("Press 'n Seal" or "Saran Wrap") prior to removal just before treatment.
Michael P Goodman MD
Davis, CA, USA
after a year treating experience, I do not like the results that are "great" but still have opening discomfort. I have been treating ALL patients with the second applicator to the outer 2 cm. around the hymenal opening. I use BLT (benzocaine, lidocaine, tetracaine) compounded cream (standard) on all people for 10 minutes before, then after (wiping it off during MLT). This has worked well. Skin is not mucosa but there is a softening result that they report as beneficial. Ouch without.
If your doctor will be treating the external vulvar tissue with the MonaLisa laser, EMLA cream may be applied to the external skin to numb it before the treatment. This makes the external treatment more comfortable. In general the EMLA cream is applied and allowed to sit on the skin for about 20min. It is then wiped off the skin before the external treatment. It is not necessary for any internal vaginal treatment
The MonaLisa laser is only for treatment of the vagina where there aren't any nerve endings that require the use of a local anesthetic.
You would only need an anesthetic cream if you are resurfacing skin on the outside. The FemiLift is a laser that can do both: tighten the vagina and treat the labia majora for a tighter and lighter looking appearance.
For external treatment, I've had my patient apply Emla one hour prior treatment with good results. You can also apply it to the vaginal opening, since this tends to be the most bothersome area for with genitourinary syndrome of menopause. Your physician can wipe the Emla off prior treatment. The internal vaginal treatment is painless, and described by most women as a vibration.
I apply EMLA to my patients undergoing the MLT if I treat the outside of their vagina. I apply a small amount of EMLA with a cotton ball and leave the cotton on top of the cream for 5-8 minutes prior to treatment
Thank you for your question.The EMLA cream is only to be applied topically and will take about 10-15 minutes to take effect.
Best of luck.
James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science
Majority of patients say they feel mild pelvic vibrations during the internal treatment of the Mona Lisa laser. Patients who have more extensive dryness, skin condition or atrophy of the external vaginal opening Elma cream is best applied for 10 to 15 minutes prior to the procedure. The area is then wiped dry so the laser therapy can be effective.