Adding more lidocaine to Juvederm voluma?

I have a very low pain tolerance, even though juvederm voluma already has lidocaine, can my doc add more lidocaine to make cheek augmentation even more tolerable or is this a bad idea?

Doctor Answers 10

I like adding additional lidocaine

Additional lidocaine can be helpful for reducing pain.
More is usually better and the additional liquid lidocaine helps the Juvederm absorb the water it is lookking for.
You will still receive the same amount of Juvederm.
Other helpful things include pre-medication (don't drive and do your consent beforehand), topical anesthetics, frozen needles, thinner needles, ice, distraction techniques, and the use of blunt needles can help.
Best wishes
Dr. Denkler

Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Lidocaine and Filler Injections

I frequently add a little more lidocaine to the fillers to give my patients more pain relief and I find it helps limit bruising.  Although most fillers now do come with some numbing in the product and you can use topical numbing, "squeez-ie" balls, and ice packs.  Best, Dr. Emer.

Jason Emer, MD
Los Angeles Dermatologic Surgeon
4.8 out of 5 stars 190 reviews

Adding More Lidocaine To Juvederm Voluma

We've never had to do this, but it can be done. Other options would be to use a topical numbing cream, performing a nerve block, or using a microcannula instead of needles. Experienced injectors will know of the best steps to take to make sure your injection process is as comfortable as possible. Best wishes.

Michael A. Zadeh, MD, FACS
Sherman Oaks General Surgeon
5.0 out of 5 stars 10 reviews

Adding Lidocaine to Voluma

There is no reason to add more lidocaine to Voluma.  We ice and numb patients with a topical numbing cream which makes the procedure very tolerable.  Best, Dr. Green

Michele S. Green, MD
New York Dermatologist
5.0 out of 5 stars 76 reviews

More Lidocaine

I have never had to add more lidocaine to Voluma in my practice but that's not to say it isn't possible. There are other options that can ease discomfort including: dental block, topical numbing cream, distraction techniques, and ice. I would find a highly qualified (and highly recommended) injector to perform your injections to ensure your comfort and safety.
Good luck,

Mennen T. Gallas, MD
Katy Plastic Surgeon
5.0 out of 5 stars 19 reviews

Lidocaine and filler

I have added lidocaine to filler in the past and it is probably ok to do. Topicals can helps as well or blocks.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews


You could add topical numbing creams or nerve blocks to make injections more tolerable.  Discuss this with your injector, but we should be able to make it as tolerable as possible. 

Jason Brett Lichten, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 18 reviews

Tolerating the pain of getting juvederm voluma

For patients wity low pain tolerance, i offer a nerve block. I theory Voluma con also be mixed with more lidocaine but it may dilute the volumizing effect.

Ana Carolina Victoria, MD
Miami Oculoplastic Surgeon
4.5 out of 5 stars 5 reviews

Voluma Pain Control / Adding More Lidocaine

While your physician can safely add more lidocaine to the #Juvederm #Voluma, the rheologic properties will not be the same.  The product will not have the same cohesive #Vycross linking.  As a result, you may not achieve the same amount of lifting with a single vial.  

Other options for for pain control include local and regional nerve blocks.  I find our patients are incredibly comfortable when utilizing #nerveblocks. 

Research and extensive clinical experience have shown injection with a serial puncture technique is superior to #cannula injections for Voluma along the cheek.  You will typically need less product to achieve the same results when using a needle for #serialpuntures. 

Best of luck,
Suneel Chilukuri, M.D.

Suneel Chilukuri, MD
Houston Dermatologic Surgeon
5.0 out of 5 stars 29 reviews

It can be done, but possibly a nerve block will be better, or different technique

In short, yes, it can be diluted with more lidocaine. There are however many other methods to reduce the pain of the procedure. Fillers IMHO are much less painful than Botox , as I personally have had both over the years. The lidocaine in Juvederm really does help. 

Technique is also important, slow injections, slow procedure. Using a cannula is also less painful than multiple injection points ( my preferred filling technique for cheeks). 

A nerve block, much like a dental block can also numb some areas around the cheek. 

Also, for nervous patients, I often use some laughing gas- Penthrox to help with the pain. 

Never problems, always solutions. 

All the best

Dr Davin Lim 
Laser and aesthetic dermatologist
Brisbane, Australia. 

Davin Lim, MBBS, FACD
Brisbane Dermatologist
4.7 out of 5 stars 75 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.