I want to have MiraDry done, but can't tolerate the pain of the lidocaine injections. What can I do?

Question

I was going to have MiraDry, but had to cancel the appointment because I couldn't tolerate the pain of the lidocaine injections. It was the most intense pain I've ever felt in my life, so bad it caused me to scream at the top of my lungs and nearly black out. I asked if I could be sedated, but they're not allowed to administer anesthesia in the office, nor can they take the MiraDry machine to the hospital. Is there any solution to this? Any doctors that will perform MiraDry under anesthesia?

Jed H. Horowitz, MD, FACS · Answer

At our office we offer Pronox to our miraDry patients.  Pronox is nitrous oxide that you can inhale safely during the procedure.  You hold the tube and inhale as needed.  It will not let you inhale an unsafe amount.  It dissipates quickly after treatment, without long term effects, so you can drive yourself home.

Robert Heck, MD, FACS · Answer

Your experience leads me to believe the practice did not have the new numbing technique that the company has trained my nurses to do. I am not exactly sure based on your story above but perhaps another consult locally would help. We have medical grade numbing cream as well  although is generally not necessary could be useful. IF they used a syringe and did injections that is outdated, there is now a numbing adapter with extremely small gauge needles that makes the numbing very tolerable. Best of luck.

Aldo Guerra, MD · Answer

There's a couple of options for you including general anesthesia which is high risks for such a minor procedure. On the other hand, a combination of nitrous (laughing gas) and oxygen mixture works well for this and other uncomfortable procedures done in office.Good luck! Dr. ALDO

William T. Stoeckel, MD · Answer

The lidocaine injections used for Miradry have been painful in the past, but there are several ways to make the experience more tolerable. Most providers are now injecting a tumescent solution instead of just lidocaine. We dilute the lidocaine with lactated ringers solution which significantly reduces the stinging sensation of the actual local anesthetic. They also make an injection device that utilizes several 32 guage needles on a disc. This device has been shown to also drastically reduce the uncomfortable feeling of the injections. The needles are the same as used for botox and are almost imperceptible when penetrating the skin. If you really needed anesthesia for the procedure, it could be done. It shouldn't be necessary with these other interventions, but could be done if you have your procedure completed at a practice that has staff to provide the anesthesia.

Estee Williams, MD · Answer

I’ve never met a patient who couldn’t do the procedure due to pain from the anesthesia injections. First, I recommend that your doctor apply a topical anesthetic cream in the office (for doctors only) for 1 hour. The skin will be nearly completely numb. Next, the anesthesia protocol is very important.  I use a tiny needle to make four blebs, at 3 o’clock, 6, 9, and 12; followed by a larger needle to numb the entire armpit with tumescent. It’s a very specific way to numb the armpit and patients love it.

Ariel Ostad, MD · Answer

Hello thank you for sharing. I'm sorry to hear that you are unable to endure the pain from lidocaine injections. At my office, we offer a product called Pronox, a gas that the patient inhales which will enable you to relax and feel more at ease. Numbing cream can also be helpful. That being said, our patients who are treated see up to an 82% reduction in sweating, odor, and underarm hair growth. For best results, please consult with a board certified dermatologist with experience.

Chien C. Kat, MD · Answer

Thank you for your question.I'm sorry to hear that you found it so painful.Sometimes numbing cream can help to reduce that pain, you may need to take painkillers and/or a sedative to help during the administration of the anaesthesia.

W. Tomasz Majewski, MD, FACS · Answer

Hello, I'm sorry that you had such a negative experience with the lidocaine injections! Everyone's pain tolerance for these things is different, but there is no reason why you should feel such intense pain during your miraDry treatment. I'd recommend asking your physician to first numb you with a topical lidocaine cream before doing the injections so that you are less likely to feel intense pain. 
You could also consider asking for a mild sedative - such as Valium - to help quell any anxiety and dull the sensation of pain. Over the counter pain medications (such as Tylenol) might also be helpful - you can take these about 30 minutes to an hour before your treatment. If you are female, I'd also suggest scheduling your appointment so that it does not coincide with your menstrual cycle, as that can increase the sensation of pain. 
Best of luck!

Jeffrey Thaxton, MD FACS · Answer

Thank you for your question.  I am sorry that the injections were so painful, we have not had that degree of pain from the lidocaine injections in our office.  We could add some topical anesthesia to decrease the pain of the injections or we have an accredited OR suite in our office and could provide sedation for the procedure if needed.  There is no reason the why we could not do the procedure under anesthesia though I suspect that we could do it with just a little sedation for the lidocaine injections.Jeffrey Thaxton, MD  FACSCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Nicholas Gentry, MD · Answer

The topical numbing lidocaine for 20-30 mins should help. I have never had anyone scream from pain from Miradry? Ask them if they are buffering the acidity of the lidocaine with sodium bicarbonate. We offer a valium for people who are anxious for procedures but not sedation.

I want to have MiraDry done, but can't tolerate the pain of the lidocaine injections. What can I do?

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