Best Approach to Prevent Pain from Radiesse Injections?

I am considering Radiesse for the nose to mouth lines but I am scared to death of the pain. My dermatologist told me they put numbing cream on your face and then inject a numbing solution before injecting the Radiesse. Is this the best way to do it? Also will I have considerable swelling?

Doctor Answers 9

Radiesse and pain

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Radiesse injection, if injected gently and slowly, can be a comfortable injection. However, mixing Radiesse with lidocaine solution and utilizing a blunt cannula can reduce discomfort, swelling, and bruising while allowing several areas of the face to be injected with multiple syringes. Radiesse is a great filler but has to be done properly to be comfortable.

Atlanta Facial Plastic Surgeon
4.5 out of 5 stars 50 reviews

Preventing pain from Radiesse injections

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The majority of my patients are quite pleased by the relative lack of pain when I inject Radiesse. I first use a three ingredient topical ointment that works well if given enough time. I then premix the Radiesse with lidocaine so it is relatively painless when injected. Soothing background music helps too. Also, squeeze balls are helpful as a last resort.

Conversely, nerve blocks are unpleasant and unreliable. Local anesthesia distorts the area and makes it harder to monitor the injection.

Everyone experiences swelling but it is usually mostly gone in a day or two.

Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 reviews

Painless Radiesse injections

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You should be able to have a comfortable experience with Radiesse. The doctor should apply a numbing cream first. There are many different kinds of numbing creams. Some are commercially available and contain one type of anesthetic, and some are made of more than one type of anesthetic and mixed according to that particular doctor's specifications. Some work faster than others, but most require that you apply the cream for at least 15 minutes before starting the procedure. I also mix a little bit of anesthetic into the Radiesse. Between the numbing cream and the anesthetic in the Radiesse you should not be uncomfortable.

However, if you are worried or if you are very sensitive to pain, your doctor can perform what is called a dental block. With a dental block the doctor injects anesthesia inside your mouth (it sounds worse than it is) to numb the nerve. I very rarely need to use a dental block. My patients tell me that the procedure is comfortable-- no one has said that it hurts, no one hasn't wanted to to it again because of the pain, and no one has asked for a dental block at their next treatment.

Jordana S. Gilman, MD
Washington Dermatologic Surgeon

Ask your physician about mixing it with anesthetic

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The best way is for the doctor to mix the Radiesse with the anesthetic and this makes the injection so much more comfortable. Most doctors are doing this now.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Painless Radiesse Injections

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Radiesse injections in the midface are a great way to restore facial volume and soften nasolabial folds. Topical numbing agents help with the needle pinch and are strongly advised. The nice thing about Radiesse is that it is now standard of care to mix the product with lidocaine just prior to injection. This essentially makes the injections pain free! Other tricks, like using ice immediately before injection and even taking a mild sedative 45 mins beforehand can limit needle phobia and lessen anxiety about pain. (Just make sure you have someone drive you home afterward!) The more relaxed you are for your treatment, the better experience you will have.

Make sure you locate a plastic surgeon or dermatologist who does a lot of injections and can talk to you about other things to do to make your Radiesse injections pain free. And regarding swelling: somewhat depends on how many cc's are injected. Ice for the first 24 hours after injections will help with swelling. Good luck and enjoy!

Randolph Capone, MD, FACS
Baltimore Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

Anesthesia for Radiesse

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A simple dental block to the infraorbital nerves can easily be done. Just as the dentist does, a medicated solution is applied to the lining inside of the upper mouth for a minute or two and then an injection is used to anesthetize the infraorbital nerves. The amount of discomfort is quite minimal and I have had many people who are afraid of needles and pain do quite well with this technique. This technique also does not cause swelling near the folds and it is easy for the physician to determine the end point for the filler. Similarly, a block can be done for the lower jaw and the marionette lines.There's no reason you can't take a mild sedative prior to the procedure but make sure you have someone to drive you and be sure to discuss what type of sedative your surgeon would like you to have.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Radiesse Injection Pain Management in Nervous Nelly

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Hi Bixa,

General anesthesia would be painless, but slight overkill.

There are ways to decrease the pain of injections. Lidocaine can be mixed into the Radiesse, lidocaine nerve blocks can be placed, and the skin should be iced before the injections. Topical numbing cream may help a little, but is usually not that effective.

In patients such as yourself, we sometimes recommend that the patient have someone drive them to the office, give them a Xanax and sometimes even add an oral or injected narcotic pain reliever.

For just your nasolabial folds, a nerve block and lidocaine mixed into the Radiesse should be all you need.

Good luck and enjoy.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Diminishing pain associated with Radiesse injection

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Recently, BioForm Medical, Inc., makers of Radiesse, received approval from the Food and Drug Administration to mix the filler with lidocaine, prior to injection into the skin. This approval was based on a large study of patients, in which 100% of patients reported feeling less pain when Radiesse was pre-mixed with lidocaine. Many plastic surgeons, including me, have begun to pre-mix lidocaine with all fillers, including Juvederm, Restylane, and Evolence, not to mention Radiesse, prior to injecting into patients. The results of treatment are still great, but patients are significantly more comfortable during treatment.

Others things your doctor can do to make your treatment with injectable fillers more comfortable include:
• Using topical anesthetic gel for at least 30 minutes prior to commencing any injections.
• Augmenting treatment with topical anesthetic gel with injections of local anesthetic into nerves above and below the lips.
• Using small gauge needles and slow injection techniques

Combining all of these treatments can ensure that you’ll not only look fantastic after your treatment with injectable fillers, but you’ll feel pretty good during the treatment too!

Hope this helps. Best of luck.

Options for analgesia (pain relief) or numbing prior to Radiesse or filler injections to the face

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There are many options when it comes to anesthetic choices. Certainly the one your dermatologist has recommended is a common approach. Another technique is to perform a dental block. Another choice is to mix the radiesses with the anesthetic. There is no one correct approach. In some rare instances, we prescribe anxiolytic medications for patients expressing mental anguish in anticipation of the procedure. Ask your physician regarding the best choice suited to your unique needs.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.