Is Prevelle Painful?

I had Juvederm injections well over six months ago. All is gone except a long "roll" down the side of my mouth. I felt that the Dr. was very "heavy handed" and tended to load up in a certain area trying to empty the syringe quickly because I was in so much pain. I'm very leery of having it again because of the pain. (I gave birth with just a Valium!) This pain was horrible!!! Now I'm thinking of getting Prevelle instead. Is this as painful? Or do you think it may have been how is was administered? I'm talking PAIN!!!! Thanks.

Doctor Answers 8

It's the Filler, not the Filler!

Hi I,

Sorry that you had to suffer through that experience. Anything that is injected rapidly is painful. The thicker the product injected, usually the more discomfort involved (i.e. Juviderm Ultra-Plus is more painful than Juviderm Ultra). There are ways to ease the discomfort of injections. Local nerve blocks are very effective. Topical anesthesia helps a little. The area can be iced immediately prior to the injection.

Preville Silk is hyaluronic acid filler that has local anesthesia. It is also a thinner product, and does not last as long as Restylane or Juviderm. Patients do feel the initial needle stick until the anesthesia takes effect. What some injectors do is lay down a small amount of Preville Silk, and once the area is anesthetized use a longer lasting filler in the same area.

I would find a physician experienced in facial filler injections who knows how to make patients as comfortable as possible. You should not tolerate a "filler" who is in a hurry or whose injections are worse than giving birth to your babies. Be well.

Dr. P

Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Minimal pain with fillers

Fillers should not be a traumatic experience! There are many ways to prevent pain during injection of fillers, and it should really be a minimally uncomfortable process. Before injection, you can have topical anesthetic cream applied to the skin, or local anesthetic injected near the nerves that provide sensation to the area being treated. Icing before injection also tends to give a numbing effect, and also temporarily shrinks blood vessels and thereby helps minimize bruising. During injection, your surgeon can use a filler that is formulated with anesthetic in the product itself. That way, as soon as the product is injected, it temporarily numbs the surrounding area. Prevelle Silk has anesthetic in the product itself, and in my experience patients really like it. Please note that Juvederm and Restylane also come in versions that include an anesthetic in the formula (Juvederm Ultra XC, Juvederm Ultra Plus CX, and Restylane L). I have found that topical anesthetic, and the use of a formula with anesthetic in the product (all of the above are good options), together offer the patient a very comfortable experience. Even in anxious or nervous patients, numbing cream followed by injection of one of the above products works really well at preventing pain. Patients who have had an experience like yours are shocked at how easy the process can be. The skill and technique of your injector does play an important role, and some surgeons are more heavy-handed than others. If you are unhappy with your results after Juvederm, Prevelle, or Restylane injection (such as the ridge you describe), you can always have the product dissolved with injection of hyaluronidase. This tends to work better the earlier it is performed. Good luck!

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Pain is generally reflective of the person behind the needle...

Although there is a certain degree of discomfort associated with all facial injectables, good injection technique can make this experience tolerable. Even though there is no way to guarantee zero pain, your injector should be able to offer various ways in which to numb you before treatment (e.g.: ice, topical numbing, or nerve blocks). Precise, deliberate injections should help minimize both discomfort as well as swelling and provide you with a result that is optimal and discomfort that is acceptable.

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
4.9 out of 5 stars 42 reviews

Shouldn't be painful

Prevelle Silk is an FDA approved dermal filler uniquely formulated to temporarily decrease the evidence of fine wrinkles and deep tear troughs. The filler is composed of hyaluronic acid, which is naturally occurring in the body and resorbed over time. Prevelle Silk differs from other fillers in that it does not swell over time and can be injected very superficially, which is perfect for tear troughs and fine lines around the mouth and eyes.

Prevelle Silk treatments are only available through healthcare professionals who are trained and experienced in dermal filler injections. The treatments are given in an office setting, where a very fine needle is guided below the epidermis and into the connective tissues within the dermal area of the face where deep lines and folds develop. There, the filler works like a sponge within the skin, where it also absorbs water, giving you a more youthful appearance.

Prevelle Silk contains a pain-numbing lidocaine anesthetic, which keeps patient discomfort at a minimum. In most cases, Prevelle Silk treatments are performed in just minutes and require little or no down time, although bruising may occur no matter how experienced the injector. Cosmetic results are instantaneous, and the younger appearance achieved in a single Prevelle Silk treatment can last up to 4 months, after which time the body safely absorbs the biocompatible filler.

The rule with filler injections is... if it feels like a lump and looks like a lump, massage it down. If it doesn't go down with massage, it can be reversed with hyaluronidase injections. If it is a lump occuring months after the filler was injected, it could be a granuloma. Granulomas occur rarely and the treatment is steroid injection. Either way, you should speak to your practitioner about your concerns.
My best,
Sheila Nazarian

Sheila S. Nazarian, MD
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 56 reviews

Any injectable filler (Prevelle included) requires an injection.

Prevelle Silk is another brand of hyaluronic acid filler (HA fillers include Restylane, Juvederm Ultra, Perlane, and Juvederm Ultra Plus) though Prevelle Silk has lidocaine (local anesthetic) added. The other HA filler manufacturers now offer lidocaine-added products (Restylane-L, Juvederm Ultra-XC, Perlane-L, and Juvederm Ultra Plus-XC).

Assuming your initial HA filler was the Juvederm without lidocaine, a "heavy-handed" injection technique can indeed add even more pain, especially in the face, where sensitive nerve endings abound! Gentle technique, and lidocaine-added HA fillers (the brand doesn't really matter, though there ARE differences you should discuss with your doctor--not the nurse at the spa) will help to make this procedure less painful. Ice ahead of time or use of topical anesthetic creams (available by prescription from your doctor) also help to take the edge off the initial needle sticks.

As you know, the best technique involves lots of tiny injections rather than a few that just shoot in a big blob of filler. (Read other posts that ask about lumps and how long they take to "go away.") Easing the discomfort of multiple injections is accomplished with the lidocaine-added formulations. Most patients find them helpful, even if there is a slight cost differential. I suspect that with competition, these formulations will become the "standard" ones, and the price points will diminish as well.

The key is finding an experienced injector that listens to your concerns, and takes the time necessary to do the best and most comfortable job possible. Lowest price is not necessarily the optimal way to make this choice!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Prevelle is not very painful when injected gently.

Most of my patients do really well with Prevelle after topical anesthetic cream or just some ice.  It does not hurt as much when injected into the lips as other fillers.  Prevelle has local anesthetic mixed in it, it is very liquid and is injected with a very small needle that limits the speed of injection. 

I would wait until the other filler is gone and then give Prevelle a try with a plastic surgeon who is patient and gentle.  These injections require a lot of finesse and a soft touch (like mine).

Lisa Lynn Sowder, M.D.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 72 reviews

Solution to painful soft tissue filler injections

Prevelle is a hyaluronic acid that is used a soft tissue filler. It has lidocaine in the syringe, so it is much more comfortable than fillers without lidocaine. It is not very thick, so I use it exclusively for the lower and upper eyelids, where it will last a long time and produce good results.

I do not use it for the nasolabial folds or marionette lines. The good news is that Juvederm just released a new formulation, Juvederm Ultra XC, that contains lidocaine. Juvederm is excellent for the nasolabial folds and marionette lines and should solve your problem. Hope this helps.

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 27 reviews

Prevelle is less painful in general


Prevelle is like Restylane with the numbing agent added. It seems to be less uncomfortable than many of the other injectable products for this reason. It only last 3-6 months though.

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 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.