Nerve blocks to fill lips with filler?

Question

Are nerve blocks ever used to fill lips with filler? Mine turned out really bad. Wondering if the nerve block could have been the problem. One side of face drew up on one side for hours.

Scott Trimas, MD · Answer

Typically, lidocaine or some other anesthetic is used for a nerve block to make injections to the lips more tolerable. The nerve block itself wears off in a maximum of 2 to 3 hours although some bruising can occur and increased swelling if a large amount was used. If you received botox in the adjacent area that may very well be the source of your asymmetry or weakness of the facial muscle. Other than that sometimes filler may be placed too high or too low and this can cause the asymmetry. However, the nerve block effects should be gone shortly after the procedure except for perhaps some bruising and swelling.

Jason Emer, MD · Answer

I typically do not use nerve blocks as they change the shape of the lips and make injections much less precise and difficult -- but this is personal preference.  I suggest getting filler performed with a cannula next time without a nerve block so you do not get complications like this.  If you are concerned of the look, please have the area reversed with an hyaluronidase injection.  Best, Dr. Emer.

Sirius K. Yoo, MD · Answer

I'd say that most injectors will use local anesthetic injected into the lips near the gum line to numb them before lip injections.  The lips are very sensitive and this can make the procedure quite comfortable after the initial numbing injections.  Having said that, one of the newer techniques involves usage of blunt tip cannulas instead of cutting needles to perform the injection.  The blunt tip cannula slides through the tissue rather than cutting through it and is thus less traumatic and painful (and less bruising).  Depending on the patient, I sometimes do not use local injections with this technique.  The asymmetry in your smile was likely due to the local anesthetic.  It will numb the sensory nerves as well as motor nerves.  If there is any asymmetry in the local injections from one side to the other, then yes, this can happen.  As you have experienced, this should be temporary (lasting an hour or so depending on the type of local used).  All the best!

Ken Landow, MD · Answer

while dental blocks may be performed, they are less popular now than previously...some people do well with only topical numbing salve or ice, but many people now favor injections just under the mucous membranes inside the mouth...and some of my patients actually prefer no numbing agents...irrespective of the choice of numbing agent, it should not interfere with the results of treatment...if your concerns resolved when the numbing disappeared, the cause of the problem was the effect of the block...not an adverse reaction to either the treatment or the numbing agent...

Elliot Lach, MD · Answer

Administering a nerve block is a matter of personal preference
on the part of the patient and physician.The typical dental type inferior or superior alveolar nerve block avoids
the potential for distortion in the lip by delivering the anesthetic fluid to a
region which is actually several millimeters away from the actual site where
the filler is to be deposited. This technique avoids the risk for marked
swelling of the lip by anything but the filler material, the latter of which is
likely going to result in pretty uniform swelling throughout the lip on a very
temporary basis. However, you will also need to be prepared for that strange sensation in your lips and to not be able to speak clearly for about an hour due to the anesthesia.  Swelling that you experienced on one side of the face could be due to bleeding from contact with either the needle used for the filling material or from the needle from the anesthetic injection. The technique and availability of "needle free" filler administration has resulted in marked reduction of the risks for hematoma and is very well tolerated without the need for traditional nerve blocks.

Travis L. Shaw, MD · Answer

Dear GynnSorry to hear that your lips turned out badly. Hopefully what you are experiencing is temporary- swelling and asymmetry can take up to 2 weeks to sort out after injection with filler. Though many physicians still use nerve blocks for the lips, they are completely unnecessary.I have done hundreds of lip fillers using a compounded topical numbing medication and blunt cannulas. This method is atraumatic, gives excellent results, and means you don't have to walk around with a numb face for hours. Many patients who came in terrified from the stories of lip injections leave smiling and tell my staff "that wasn't bad at all."I hope things work out well for you and that this information proves helpful. BestDr S

Darryl J. Blinski, MD · Answer

I doubt the local injection effected the filler injection. If you had a swelling than the cause is the filler hitting a vessel most likely...

Nerve blocks to fill lips with filler?

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