Juvederm Without Dental Block & Topical?

Question

I'm having my lips done Tuesday. The nurse at the office said they don't use a topical cream or dental block, the juvederm has lidocaine in it. The woman that does my eyelash extensions had her lips done by my plastic surgeon and said she got a dental block though. I'm nervous...how painful is it without getting a topical cream or dental block?

Donald B. Yoo, MD, FACS · Answer

The lips are probably the most sensitive treatment area for Juvederm. Most patients would likely agree that the extra comfort derived from 20-30 minutes of topical numbing, or undergoing a dental block, is well worth it. Relying on the lidocaine that is contained in Juvederm alone to provide sufficient anesthesia is not the most comfortable option.

Jerome Edelstein, MD · Answer

Patients find Juvederm with lidocaine far more comfortable of a treatment, although it really depends on how sensitive you are and the injection technique applied by your injector. For example, when doing the lips a microcannula can be used which would help reduce the discomfort associated with treatment. Ask your injector if they'll be using a microcannula.

Kenneth Hughes, MD · Answer

Injection of the Juvederm into the lips is technique dependent as is all filler injection. In addition to placing the filler into the proper areas in the proper amounts, the method of injection contributes much to the experience. Pinching, ice, and fast injection all help.

Sam Naficy, MD, FACS · Answer

Most people feel the lips are the most sensitive area on your face. We have three times the nerve endings in the area between the nose and the upper lip. So It is a pretty sensitive area to inject. Unless you have a high tolerance for pain, I would recommend at least a topical numbing agent and ice. Even though Juvederm does have lidocaine in it, it doesn't help with the initial needle pricks. Many offices offer dermal fillers and I'm sure you can find someone who offers numbing prior to the treatment.

Eric Swanson, MD · Answer

First of all, the topical numbing creams are not all that effective and must be applied at least half an hour before the procedure if they are to work.  The problem with dental blocks is that these injections hurt and leave your mouth with that uncomfortable numb feeling that takes an hour or two to go away.  They are also not completely effective.  I'm not convinced that the advantages outweight the disadvantages!

	 

	I prefer to simply inject the Juvederm using a long, narrow needle and injecting as I withdraw.  This technique minimizes needlesticks.  In fact, the doctor's technique is very important in reducing pain.  Done properly, this is no longer a very painful procedure and takes less than 5 minutes.  The lidocaine in the Juvederm also helps a lot.  So if your doctor tells you he or she does not use dental blocks, that's okay.

Michael I. Echavez, MD · Answer

Pain tolerances vary from person to person. Many people can tolerate injection of Juvederm without a dental block or a topical anesthetic. However, the pain is reduced with use of a topical anesthetic or dental block. You should discuss your concerns with you doctor and you should be able to come to a decision as to what type of anesthesia to use.

Sabika Karim, MBBS · Answer

Dear Melissa, 
Thank you for your question. In our personal experience lips can be one of the most sensitive areas to treat so we would always use a topical numbing cream for 20-30 minutes before the procedure. 
We don't use dental blocks in our clinic as we find the numbing cream is adequate enough. 
Wishing you all the best

Benjamin Barankin, MD, FRCPC · Answer

The new Juvederm which has anesthetic embedded into it has dramatically reduced the pain and discomfort of my patients from about a 5-7/10, down to a 2-3/10 pain. Lips are the most sensitive area for fillers, but I have found the new formulation along with ice packs to work beautifully with modest short-time discomfort that has not necessitated any nerve blocks. If you're pain conscious, take 2 tylenols 1 hour before your treatment, and consider having a topical anesthetic applied. There are also special techniques to reduce pain that dermatologists and plastic surgeons are well-versed in. Dr. Benjamin Barankin, Toronto Dermatology Centre.

Pamela Carr, MD · Answer

I routinely use a nerve block when injecting filler (such as Juvederm) for lip augmentation. In my experience the inconvenience and discomfort of the block is worth having the patient comfortable and relaxed for the procedure.

Stephen M. Chen, MD · Answer

The new formulation of juvederm with lidocaine is truly night and day compared to the previous generation. I routinely used dental blocks prior to this combination. Now I will occasionally use topical agents but I usually go with ice followed by injection of the white roll to numb up the lip. Topicals do take the edge off, however, if you decide to go with this, show up half an hour earlier to have it applied prior to injection. Better yet to ensure no mix ups make arrangements with the staff that if you do show up early, to make sure you get the topical and are not just sitting around the office. Please relay your concerns with your doctor, if he or she does not respond, feel free to find someone who will spend the time of listening to your concerns and acting upon them. Good luck with your lips, I hope that you like your results and I hope that your experience will be a pleasant one.

Juvederm Without Dental Block & Topical?

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