Is Juvederm for Lips Painful?

I went a couple days ago to get my lips plumped up with Juvederm. The MD applied a topical anesthetic and then proceded to give a local one like you get in your gums at the dentist. It was so painful that I fainted. I didn't even get to have my lips done. I'm too scared to go back and finish the procedure but I paid a lot of money. Is there any way this can be completed with out me having to pass out from the pain? Should lip injections hurt this bad?

Doctor Answers 46

Juvederm placed in the lips can be painful if no local...

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Juvederm placed in the lips can be painful if no local or topical is used. Some of my patients take it "cold" - no anesthetics. Most take at least a topical.

For the more sensitive patients, I will often place a topical on the skin for 30 minutes, and add a viscous lidocaine solution to be placed along the gum line inside the mouth for about 5-10 minutes prior to performing nerve blocks. This makes the lip completely anesthetic and very easy for the patient.

I am sure you were just very nervous, and that is why you fainted. My patients often comment on how easy the procedure went.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Have your doctor mix Lidocaine with Juvederm

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That must have been really painful to faint like that.

Make sure the physician leaves the topical anesthetic on 30-40 minutes. Perhaps, after your experience, the doctor has found another pharmacy to mix up his anesthetic formulation. We have found our topical to be wonderful, after trying two others (one including Pliaglis).

I find Morita's Hurricaine sticks to be helpful under the lip and in the area for the dental block. Then the dental block should be performed knocking out the infraorbital and mental nerves.

Agree with the adding Lidocaine to the filler helps and slow injection techniques.
Not that I agree with this but some physicians, prefer not to do a dental block. They feel that the dental block can distort the lips.

Using the above measures should make lip augmentation much less of a harrowing event for you.

Arnold R. Oppenheim, MD
Virginia Beach Dermatologist

Anesthesia with Lip Augmentation: Juvederm, Restylane. Towards painless lip augmentation

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Lip Augmentation with facial fillers such as Juvederm and Restylane is a very common procedure. Although pain tolerance between patients varies considerably, there are many topical, injection technique related, and infiltrative anesthetic treatments that can minimize pain.

A reasonable approach to anesthesia for lip augmentation should focus on the following techniques:

  • Local anesthetic block of the infraorbital nerve and mental nerves
  • Topical anesthesia of the inner lip mucosa and the outer lip skin
  • Bolus injections of lidocaine into the upper sulcus and lower sulcus to reduce any ancillary nerve fibers
  • Use of a smaller needle.

If you are still having pain after the first injection, have your practitioner apply more topical anesthetic and injection. Be aware that anesthetics have toxic doses and only an experienced medical physician should be injecting these medicines.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Dental Block!!!

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The lips are exquisitely sensitive!  I would never inject lips without a dental block first.  The dental block is nearly painless to perform, takes but a few seconds, and results in completely numb lips for about 20 minutes.  Topical ointments simply don't do the job.  Any doctor serious about injecting your lips more than one time should offer this service.  Any doctor who would like repeat and business and patient referrals should include the dental block as part of the routine at no additional cost as do I.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

Juvederm Injections: Pain Tolerance Varies

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Pain tolerance varies from patient to patient when injectable fillers are used. In some cases, patients are able to undergo the procedure without anesthesia, while in other patients, anesthesia is an absolute requirement.
The lips have a high density of sensory nerves and for this reason are very sensitive to pain. Pain thresholds vary from patient to patient for a variety of reasons including anxiety. In some patients this procedure can be performed without anesthesia; while in others this would never be a consideration. Based on your history, quality anesthesia was never really attained and as a result the procedure was discontinued.
Clearly alternate strategies are necessary to make this a comfortable experience. Multiple options are available for anesthesia under these circumstances. These include topical agents, injectable agents and drugs that address anxiety. In many cases slowing down the process and using these tools in combination can make this a more comfortable experience.
Topical anesthetics are relatively easy to use. These agents are simply spread over the area before the procedure. They take approximately 10 to 15 minutes to work and are moderately effective. The administration of these agents is pain free, but doesn’t totally alleviate pain from the injection of dermal fillers. They can also be used intra orally prior to intraoral anesthetic injections.
When using injectable fillers nerve blocks with local anesthetics are extremely effective. This procedure is performed by infiltrating local anesthetic intra-orally in the area of the infra orbital and mental nerves. This effectively provides anesthesia of the upper and lower lips and surrounding areas. This approach provides excellent anesthesia which is almost instantaneous.
Treating anxiety with Valium is also helpful when these situations arise. Using topical anesthetics prior to injections and giving these drugs adequate time to work is important as well. When injecting local anesthetics, it’s important to inject slowly to avoid unnecessary pain. When these steps are taken treatment with injectable fillers can be a much more comfortable experience for patients.

Fainting from the pain of a shot of xylocaine may have something to do with

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your pain threshold and some undue anxiety about the whole process...and some people are much more prone to faint than others....sounds like a likely and actually not a rare situation...the solution may be to take a mild anti-anxiety pill an hour or two before treatment and have someone drive you to the appointment...and of course the topical numbing medicine for a reasonable period of time in the area where you'll be getting the xylocaine...if you can't tolerate even the xylocaine injection the likelihood of your tolerating the injections without any locally injected numbing medicine is nil...and if you and the doctor can't find a way to anesthetize your lips, sure he'll gladly refund the most or all of the money...

Ken Landow, MD
Las Vegas Dermatologist

Juvederm in the lips does not have to be painful

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I am sorry to hear of your discomfort with lip injections.It doesn't have to be that way. We use a really fabulous topical numbing agent mixed by a pharmacist on the lips for 30 minutes. Then I apply the topical under the lip that the dentists use called Hurricaine. We wait a couple of minutes for that to work and then I do a miniature dental block. This gives me 20 to 30 minutes without feeling in your lips.

It also helps if the doctor is injecting the products that have Lidocaine added. If they did not buy it that way they can add it to the filler if they have the adapter for mixing.

With all these steps you should be very comfortable. Also,be sure you have eaten something with a little protein a couple of hours prior to the treatment. Some patients get light headed because their blood sugar drops from the aprehension of the treatment.

It never fails that the noon patient has not eaten since dinner the night before.

I hope this helps and makes your next doctor's visit a bit easier.

Esta Kronberg, MD
Houston Dermatologic Surgeon
4.9 out of 5 stars 28 reviews

Lip Augmentation Can and Should be Painless

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Lip Augmentation, with Juvederm or any other product, can and should be painless. A skilled surgeon can administer an infraorbital nerve block with essentially ZERO pain. While this can be a painful block if not performed well, when it is done right patients feel almost nothing.

Once the block has been placed, the lips are totally numb to the lip augmentation procedure, and even surgery!

Good luck,

Mike Nayak, MD

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 230 reviews

Lip Injections can be painfree if a good lip block is done

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Doing beautiful lips is an art but doing them painfree is also a skill that varies among physicians.  While dental blocks are helpful, they often don't numb the center of the upper lip very well, which can be the most sensitive area, and can take 15-30 minutes to take effect.  A good "lip" block which is not as deep as a dental block but just numbs the lips can numb the entire lip in most patients 90-100% within minutes.  A topical spray called "Pain Ease" also is very helpful if patients prefer to avoid the lip block (if they don't like the "been to the dentist" feeling) and use one of the newer filler products that contain lidocaine, such as Juvederm  Ultra XC.  This technique might be a bit painful in parts because the lips will not be 100% numb but it can be very tolerable with the two products used together.

Lorrie Klein, MD
Laguna Niguel Dermatologic Surgeon
4.9 out of 5 stars 217 reviews

No need to have any pain

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Juvederm to the lips are painful if you do not get adequate anesthesia.

I usually do nerve block (like the dentists use) to numb the lips. Once the lip is completely numb, I do the injection.

Next time, ask for nerve block.

Payman Simoni, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 34 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.