Tips for Avoiding Radiesse Pain

Question

I am thinking about getting  for my marionette lines, but after reading a , I'm not sure.  She described the Radiesse injections as being so painful that I am scared to try it.  Why do  injections hurt so much for some people, but not others?  How can I avoid being one of the people who has "excruciating" pain?

Raffy Karamanoukian, MD, FACS · Answer

Facial fillers are useful to correct areas of facial atrophy, including the lips, nasolabial folds, and face.  Injection is usually performed using small gauge needles that are prepackaged with the sterile syringe.
Minimizing pain is an important part of your overall experience.  There are many ways to minimize the pain associated with facial fillers, including the topical application of lidocaine creams, local anesthetic blocks, and local injection of anesthetic prior to injection.
The most recent development in facial filler injections has been acheived by mixing the anesthetic with fillers such as Radiesse prior to injection.  This reduces the pain associated with the injection and obviates the need for local anesthetic blocks.

Anil R. Shah, MD · Answer

There are several steps to minimize pain with Radiesse:

	
		Pre and post injection icing can help numb the sensation to the area
	
		Proper injection technique can eliminate most of the discomfort associated with it
	
		Dental blocks and topical anesthetics are not necessary in my practice for Radiesse (see point above)
	
		"Tricks of the trade", in which each injector employs including various distraction techniques and others to minimize discomofort


	Radiesse injection should be a relatively pain free experience.

Houtan Chaboki, MD · Answer

Injectable fillers such as Radiesse, Restylane, Juvederm, and Sculptra are good options for various cosmetic enhancements for facial aging, such as nasolabial / smile lines or lip enhancement. 
Some local anesthesia is generally required, since each filler is injected via a small needle. However, cosmetic treatment should not be very painful. Most dermatologists or plastic surgeons use a combination of anesthesia techniques to minimize discomfort.

topical anesthesia cream on treated areas
nerve or dental block with injection of anesthesia into skin & tissue
mixing anesthesia directly with the filler
ice pack prior to procedure
oral pain medication prior to procedure

There are many other techniques which may help alleviate any pain with injections.

Stephen Prendiville, MD · Answer

There is no filler procedure which "has to be painful". There are many tools in the analgesia armamentarium which can minimize or eliminate pain from the technique. The first step is to apply topical numbing cream for about 15 minutes. The second step is to give small pinpoint injections of lidocaine in the spots where the Radiesse needle will enter the skin. The third step is to mix the Radiesse with a little bit of lidocaine. This approach has been very helpful to my patients and makes the procedure much more comfortable

John L. Burns Jr., MD · Answer

My advice is to have your physician use numbing cream which needs to be applied 1 hour before the procedure and rubbed into the skin. I also recommend mixing the Radiesse with a small amount of lipocaine with epinephrine (adrenaline) to decrease the pain and to prevent bruising. I also apply ice or cold compresses to the skin immediately before and after injections.

Farhad Rafizadeh, MD · Answer

I usually inject the area with minute amounts of local anesthetic with epinephrine that will numb the area and shrink the blood vessels so that it is less likely that the Radiesse could be injected in them. Some people mix the Radiesse with a local anesthetic bot this doesn't totally eliminate the pain.

Edward E. Dickerson, IV, MD · Answer

There are ways to minimize pain associated with facial fillers. Ice, topical anesthetics, lidocaine or nerve blocks can be used.  Slow injection technique as well as mixing with lidocaine works well.

	"Dr.D"

Michelle Copeland, MD, DMD · Answer

Radiesse is firmer than most fillers, so it’s a frequent fix for deep grooves and to enhance bony contours. It is now virtually painless because it is mixed with lidocaine which numbs the areas as it is injected. Many patients even report that Radiesse injections are less painful than Botox!
	But buyer beware--injection techniques can vary. It’s the art and science of what doctors do, and it’s important to choose your doctor wisely. I suggest finding a physician with plenty of experience using this product.

Robert L. Kraft, MD, FACS · Answer

I prefer to use nerve blocks to numb the areas to be injected or local anesthesia.  After that, the patient is totally numb.  Topical creams take the edge off the injections but don't significantly reduce pain below the skin surface.  Some patients who are anxious about the injections take Xanax before treatment.

Vineet Mehan, MD · Answer

Radiesse usually in my experience is not painful for multiple reasons.
1. Use numbing cream.  Have the cream massaged in 1 hour before and again 1/2 hour before injection.
2. Mix Radiesse with local anesthetic. (ask your plastic surgeon/derm injector to do this if you have to)
3. Tiny shots for a nerve block before hand can give complete numbness and a pain FREE experience once the blocks are done. (again, you can request this from your experienced injectors.)
It should be a relatively smooth experience if you go to an experience injector who is specifically trained and knows radiesse.
Again, make sure the radiesse is being injected to deeper areas. Not lips or the "tear trough" deformity under the eyes.
Remeber radiesse can not be reversed with a second injection as the hyaluronic acid fillers can (juvederm/restylane/perlane/prevelle/etc.)
Good luck!

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