There are many ways to administer local anesthesia. Some means are more comfortable than others. I personally like to start by topically numbing the skin with anesthetic cream. No matter what else, this take a big bite out of any discomfort. For procedures like BOTOX and fillers, this is more than enough anesthesia for almost anyone. Even lip edge treatment is pretty tolerable with the use of fillers like Restylane-L which contains the local anesthetic lidocaine. For surgical type procedures in the office, I will use pH adjusted products like Septicaine which does not sting. I also have a device called the Wand, which is a computer driven pump that administers local anesthetic much more slowly than humanly possible. Using this combination of techniques, people are pleasantly surprised how comfortable the process can be.