Restylane on Nasolabial Folds Without Dental Block?

I am considering Restylane to the nasolabial folds but had a bad experience with a dental block so I don't want to go through that again.

Is it very painful to do this without a block? I have heard some doctors don't use more than simply a numbing cream, but another doctor said it's excruciatingly painful without at block.

Doctor Answers 12

Restylane without a dental block

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Most of the Restylane I inject is done so with solely topical anesthesia. In other words, we do not do a dental block. This is an individual preference and I find that the nasolabial folds do fine without requiring a dental block. People tolerate this fine. However, the lip border when treated with Restylane is very painful and a dental block is extremely helpful. Regardless, I have had some patients that do not want a dental block for this area either.

West Palm Beach Dermatologic Surgeon

Actually, we add anesthetic into the Restylane at my office and it makes it nearly painless

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You can add anesthetic into the Restylane and that makes it pretty much painless, but you have to add numbing cream on the area as well. This makes a huge difference and can improve the likelihood of not bruising as well.

As you can see from the responses, most of the people doing this procedure don't do this, which is a shame!

Most patients prefer a light local block before filler injections

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Although topical anesthetic creams can be used, you must wait for a period of time until they are effective before undergoing the injections. Without question most patients prefer to have a light local block before injection of fillers. The anesthesia wears off in an hour or two. The addition of epinephrine in the solution helps to prevent bleeding from the injections. Only a very few brave individuals can tolerate multiple injections without any anesthetic.

Jack A. Friedland, MD
Phoenix Plastic Surgeon

Restylane without dental block

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I have performed Restylane to the Nasolabial folds with and without anesthetics. It is more comfortable with an infraorbital nerve block and you don't specify what problem you had. However, without a block or with topical BLT it has been well tolerated since the injections are fairly quick. I haven't had anyone state that it was "exruciting" even without the anesthetic.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Restylane is commonly done without nerve blocks

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Restylane is more commonly done without a block for the smile folds. When slow technique is used the pain is less. Only numbing cream is used for this area in my practice and although there is discomfort most people do not find the smile folds too painful. The lips are more tender and I tend to block those.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Occluded topical anesthetic

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Dear KGB

The reality is that we all differ in our perception and tolerance to pain. What works for many may or may not be right for you. I have several patients who because of their extreme intolerance to discomfort and associated panic disorder actually get their Restylane treatments under iv sedation at a surgery center. This is the ultra extreme not the routine. For the vast majority, occluded topical anesthetic makes nasolabial treatment very comfortable. Some are more uncomfortable with this treatment.

Again what works for others may not be right for you. Ideally, your injector should be sympathetic to your concerns and work with you to find a way of delivering your treatment that maximized your comfort.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Resytlane in Nasolabial Folds without Dental Blocks

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It is not that painful. The trick is to use a numbing cream in advance. Wash the face, put on a thick layer of Emla cream one hour before your injection. Then request the physician to mix the Restylane with a small amount of lidocaine to take away the sting of Restylane.

Following these directions the pain should be minimal.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon

Restylane without nerve block

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The procedure is more comfortable with an infraorbital nerve block; however, most people find the injections tolerable if topical anesthetic cream (the strong stuff found in doctors' offices) is placed 30-45 minutes prior to the injections. You may want to try the cream first and if you then find the injections intolerable, go for the nerve block.

Good luck.

Bryan K. Chen, MD
San Diego Dermatologist

Many options for anesthesia

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Pain tolerance is a very individual thing. I see a wide range in my patients. Some patients can get fillers without any anesthesia. Some find simply holding an icepack to the area before injection takes the edge off. Topical anesthetics can also help. Recently I have had great success with Juvederm with Lidocaine. This product has the lidocaine anaesthetic built in. You feel the first needle prick and injection, but after that, with a patient injector, the anaesthetic kicks in and you should feel very little discomfort.

Julia Carroll, MD
Toronto Dermatologist

Most patients do not need a dental block for Nasolabial fold Restylane

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Most patients can be comfortably treated with Restylane or Juvederm injections in the Nasolabial Folds (parenthasies area) without an injection of anesthetic.

  1. I would suggest that you place anesthetic cream (BLT-Benzocaine, Lidocaine, and Tetracaine) on the area to be treated one our prior to your treatment. You can ask your doctor to give you a small amount of the cream so that you can apply it prior to the visit. It is fine for you to apply the cream to the nasolabial fold area or other localized areas of your face. However never use BLT cream on a large area of your body without specific instructions from your doctor.
  2. We also mix a small amount of anesthetic with the Restylane, or Juvederm prior to injection. This is an off lable use of medication however we have found it to be safe and very effective in making the Restylane injection more comfortable.
  3. Finally, techique matters for the end result and the comfort. Injections should be given at a slow gentle rate. This reduces bruising and discomfort.

Hope this is helpful

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 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.