What type of local anesthetics are available for lip fillers so I don't feel anything (especially pain) at all during procedure?

Question

I've had juvederm twice injected into my lips. Both times the offices would only put a white-colored, surface-numbing cream on my lips. But I have seen videos of people having a gel added to the inside of their mouth and they feel NOTHING at all during the injection. Even though I have that surface cream - I still feel the needle poking and jabbing inside my lips and it hurts! Why don't the offices offer a more painless option? I know they're out there - what are they?

Harold J. Kaplan, MD · Answer

Hello,I'm not sure how a practitioner can ever claim that the procedure is pain-free.  Traditionally, this is a very tender area.  Practitioners that are mindful of the discomfort associated with this treatment will rely on numbing cream, icing throughout the treatment, Arnica gel, and a gentle hand combined with comfort measures.  As mentioned, the fillers now come with lidocaine (pain medicine) mixed in with the gel.  Unfortunately, this only helps after the treatment has begun...hence, the use of topical numbing cream and ice.  We choose not to use nerve blocks (dental blocks) as these injections are painful in themselves, this takes more time and expense, and most importantly, the complete lack of sensation causes the patient to not hold their mouth/lips in a more natural way which may hinder the artistic approach.  Choose a practitioner that is mindful of your concerns with pain and offers options to address this.

Jason Emer, MD · Answer

Cannulas, numbing cream, ice, and pro-nox can be used to limit pain during injections. I recommend getting a formal evaluation with a cosmetic dermatologist. Best, Dr. Emer

Stephen Prendiville, MD · Answer

The lips and perioral area are, by evolutionary design, a very sensitive area.  Although topical agents provide some relief and most fillers are mixed with or manufactured with lidocaine, some patients are more pain sensitive than others. If the patient is visibly uncomfortable despite the above measures, I will use a nerve block to completely eliminate pain.  The trade off is that nerve blocks can be uncomfortable and the perioral area is numb for several hours afterward.

Gregory Roche, DO · Answer

In my opinion, injected anesthetic can change the lip with swelling. However you can use topical creams and dental blacks can also be used. Many fillers contain Lidocaine so upon injecting, patient goes numb.

Kouros Azar, MD · Answer

There are a few things that you can do. The topical numbing cream with ice is the first step. Then, see if your injector has the Juvéderm mixed with lidocaine. This helps most patients. If that isn't enough, you could always use a nerve blocker.

Jennifer Trent, MD, FAAD · Answer

In addition to topical numbing cream, you could ask your physician to give you a nerve block.  However, with the use of cannulas, ice, and the newer HA's mixed with lidocaine, the procedure is tolerable.

Camille Cash, MD · Answer

There are several techniques that can be used to minimize pain during this procedure.  The lips are a very sensitive area to inject.  Topical numbing creams and ice can be used.  Juvederm is available with lidocaine mixed in the product for comfort during injection.  You can opt for a nerve block if necessary which is similar to what the dentist does during dental work.  Speak with your injector to determine what is right for you.

Leonard Grossman, MD · Answer

In the last nearly 25 years of lip augmentation done by me, I have developed a technique where I don't even use numbing creams or any numbing medications around the mouth except for what is present in the Juvederm. Nerve blocks work exceptionally well in patients who are terrified of needles. But I find that it's usually not necessary. My patients always say how surprised they are that the procedure was painless.I am sure that if you find an expert in the field of plastic surgery in your area they will be able to provide you with a relatively painless experience of lip augmentation. Good luck from New York City

Julian W. Dixon, MD · Answer

Good question. The lips can be a very sensitive area to treat with filler. Some patents are just fine with ice or a little numbing gel, some patients may require local nerve blocks. The amount of anesthetic required differs from patient to patient, which is why the one of the most important features of a provider is the ability to perform various types of anesthesia. Hope this helps.

Steven Wallach, MD · Answer

You are talking about intraoral viscous lidocaine which can be used prior to injecting nerve blocks intraorally.  Most patients that I treat just go with the topical you had on your lips because I think in most cases nerve blocks are excessive.

What type of local anesthetics are available for lip fillers so I don't feel anything (especially pain) at all during procedure?

Answers (10)

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