How is the number of lidocaine injections per arm determined in a miraDry procedure?

Question

Some have stated that they have had 30 or more injections per arm. I had 4 on the right side and 6 on the left. My left side was bruised and swollen for 4 weeks.

Payman Kosari, MD, FAAD · Answer

I've narrowed it down to 3 needle sticks per axillae.  From these 3 needles sticks, the whole armpit is tumesced (numbed).  I have posted a video of it being performed.  Hope that helps

Larry S. Nichter, MD, MS, FACS · Answer

The number of injections has to do with the person performing the procedure, and neither is bad, but that fact that you only had 4 on each under arm tells me that they used tumescent  which helps you have less injections. I hope this helps.

Aldo Guerra, MD · Answer

These injections are designed to numb you up. Even with an experienced provider, in some cases you have make more injections to get a patient completely numb. It’s not predetermined as there’s too much variety in the anatomy. Good luck! Dr. Aldo

Susan Van Dyke, MD · Answer

The amount of numbing lidocaine injected for a miraDry procedure depends on the size of the person.  Bigger people have bigger armpits and need more volume of the numbing solution. The new technique uses smaller needles so less discomfort and less bruising.  Keep in mind that the numbing solution is very dilute so the risk of too much medication is very low.  Swelling after miraDry is very common more because of the treatment, not the numbing.

Quenby Erickson, DO, FAAD, FACMS · Answer

The injection techniques can vary between offices. We use the High Volume Anesthesia technique which is also called Tumescent Anesthesia. The very dilute anesthesia is injected with very little discomfort and typically it is only the first couple of injections that you feel. With this technique, you have the highest level of protection for the nerves that go through the underarm area to the fingers and because of this technique's safety, we are able to treat everyone with the highest level of energy and better results.Dr. Quenby Erickson, DO, FAAD

Scott Gerrish, DO · Answer

pcd10011:
Historically, there have been two different techniques to deliver anesthesia in preparation of the miradry procedure. A point-to-point injection technique requiring 30+ injections per underarm or a tumescent technique utilizing a longer needle to deliver the lidocaine through 2 or more injection sites. The main priority for the anesthesia is to numb the area thoroughly so the treatment is pain free. 
With the 2018 launch of the Miradry Fresh protocol, the all-new syringe adapter  technique has been introduced to make the numbing process more comfortable and less intimidating for the patient. 
Be Well

Grant Stevens, MD · Answer

Everyone has a different technique on how to numb for miraDry.  The key is to have the area numb, how many injections do not matter.  Hope this helps.

Shareef Jandali, MD · Answer

The number of lidocaine injections for miraDry is mostly technique dependent, depending on how your provider numbs the area.  The same amount of fluid in injected when using the tumescent technique, and depends on the size of the underarm.

Craig Schwartz, DO · Answer

There are 2 approaches to numbing for miraDry. The original or older approach was to use multiple separate injection points to cover the entire region, with the number determined by the size of the treatment zone, but often numbering up to 20-30/side. The newer, or better, approach is to use tumescent local anesthesia in a subcutaneous fanning technique. This can be done with as few as 2 or 3 injection points/side, and is much more comfortable for the patient. Ask your provider which technique they use, but I highly recommend the latter.

Robert Whitfield, MD · Answer

It i typically 4 injection sites to have the ability to numb the entire area.  It can be done with less.  The goal is to get the fluid delivered so that the treatment is as comfortable as possible.  There is a mixture we use that allows it to be done easily.  We also use ice and anti-inflammatories afterwards.

How is the number of lidocaine injections per arm determined in a miraDry procedure?

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