A nerve block is not necessary for most injections. You can request a numbing cream, most injectable clinics carry a version of this product. The cream is applied externally to numb the skin and the local anesthetic in the product will take care of any pain within the tissues.
Yes, you can but it is not necessary.The Juvéderm Ultra XC has a local anesthetic in it so it will numb the tissue and the injection is virtually painless. I use a blunt cannula for the injection and will inject the Juvéderm Ultra XC before advancing the cannula, making the injection virtually painfree. The use of a blunt cannula is also safer as it will not cut any nerves or blood and there is virtually no bleeding or bruising.
Yes, you can have nerve blocks performed externally. This is easier for the upper lips as you can actually feel where the nerve is. For the lower lip, the injections are more precise when looking at the lower jaw. I agree with Dr. Stolman that numbing cream, ice, distraction and "talk-esthesia" are usually totally effective. However, nerve blocks can be effective if other methods are not. I hope this information is helpful for you.
Stephen Weber MD, FACS
Denver Facial Plastic Surgeon
A topical prescription-strength numbing cream is usually adequate if applied properly and left in long enough. Plastic wrap or Saran Wrap can safely be placed on top of cream to improve the penetration, as long as the quantity of cream is limited to a face-size application. Many of the fillers now contain lidocaine numbing medicine mixed in, so there is just a small needle poke on the overlying skin. The lips are the most sensitive and need thorough numbing for comfort.