Juvederm Without Dental Block & Topical?

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?

Doctor Answers 16

Juvederm for lips without topical or dental block

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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.

No dental block or numbing cream

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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.

Level of discomfort associated with lip augmentation with Juvederm

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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.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

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Discomfort associated with Juvederm

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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.

Benjamin Barankin, MD, FRCPC
Toronto Dermatologic Surgeon

Juvederm for lips ... Most comfortable way

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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.  

Pamela Carr, MD
Sugar Land Dermatologic Surgeon

Juvederm injections now include a local anesthetic so dental blocks are unnecessary

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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.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

Lip augmentation without numbing

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Every patient has a different level of pain tolerance.  Topical numbing cream often helps blunt the initial poke with a needle, but with the lidocaine mixed into most of the fillers, the area soon goes numb after the first injection.  Many patients can tolerate the lip augmentation without numbing, but the lips are very sensitive and may be uncomfortable for you.  If this causes you anxiety about your lip injection then ask your doctor about numbing options.  Most likely your plastic surgeon has topical numbing medication or can perform a nerve block if you request it. 

Jessica Kulak, MD
Fairfax Facial Plastic Surgeon
4.6 out of 5 stars 27 reviews

Juvederm to lips without dental block or topical anesthesia

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It all depends on the type of person you are.  The majority of patients in my practice prefer some sort of numbing prior to lip enhancement with injectible fillers.  The topical agents have gotten much better, so we do fewer nerve blocks than we did 2 years ago, but some patients prefer this.  The downside to nerve blocks is the strange sensation that can persist for some time and many people are glad to be free of them now that good topical agents are available.  About 5% of my patients prefer NO anesthetic, either block or topical.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Anesthesia for lip injections

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I would never do lip injections without some form of anesthesia. In my opinion, nothing compares with a dental block. After swabbing an area on the mucous membranes inside the lip with a numbing solution used by dentists (called a Caine Tip), I inject a local anesthetic (lidocaine) at several points to completely block the nerve sensory fibers from reaching the lip. It is quick and relatively simple to do, quite reliable, and results in almost painless injection treatments for lip enhancement. 

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.4 out of 5 stars 13 reviews

Juvederm without dental block or topicals

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Personally, I inject all of my filler patients with blocks. One, it helps with their comfort and two, because I use lidocaine with epinephrine, it helps prevent bruising and swelling. Quite simply though, some injectors are not able to use dental blocks because they aren't physicians. Are you seeing a nurse or other injector for your Juvederm? If so, this would be the reason. The other thing is that some people just don't think it's necessary because it does add a bit of time (and minimal cost) to each person. However, what I tell my patients is that I'd never do something to them that I wouldn't want done to me. So, I use every way to minimize pain and allow for the utmost in patient care and comfort.

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.