Can local anesthetic (lidocaine, etc.) be used before injection of upper eyelid (i.e. orbital rim) filler? (photo)

Question

My upper eyelids (well not the upper eyelid itself but hopefully you know what I mean - the orbital rim I think) are starting to look hollow due to age and also I had a browlift which I think contributed to the problem. I'd like to get some filler in that area but the doctor I visited said he couldn't use any anesthetic because it would be too difficult for him to see exactly where to fill. Do any doctors use local anesthetic before injecting in that area? I have very low pain tolerance:(Thanks!

Andrew P. Trussler, MD · Answer

Local anesthetics can be injected prior to filler injections. Typically if the injector is concerned with accurate placement of the filler, a nerve block can be performed which is typically injected into the origin of the nerve which supplies sensation to the area of injection. This is well away from the area of injection and safe to do. Topical numbing cream can be applied as well. Both should adequately anesthetize the area of injection prior to adding any volume. Most fillers do have lidocaine in them, but for lip injections and lower eyelid injections, nerve blocks work well.

Jeffrey Joseph, MD, FACS · Answer

Certainly either an injection of lidocaine can be done, but I prefer a topical anesthetic gel placed approximately 30 minutes prior to injections.

Jason Emer, MD · Answer

In this are cannulas are easier, have less bruising and swelling and cause no distortion of tissue, and the patient feels no pain.  I use these for injections in sensitive areas such as around the eyes.  I agree, I do not like to locally or as a nerve block inject lidocaine because it can distort the tissue making your filler placement less predictable.  I suggest going to an expert for treatment in this area, as it is a very delicate area that takes a pro.  I would gladly treat you anytime.  Best, Dr. Emer.

Stephen Weber MD, FACS · Answer

I would agree that injecting local anesthetic distorts the tissue in this area. Further, it hurts more than the filler itself. Some ways to approach this issue are to find a physician injector who will use topical numbing cream as well as a cannula (as opposed to a sharp needle). This approach tends to minimize pain, swelling and bruising. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Ramona Behshad, MD · Answer

Topical anesthetics are commonly used prior to filler injections. They deaden skin sensation without distorting the treatment area. I use a cream that combines betacaine/lidocaine/tetracaine. It needs to be applied to the skin for approximately 45 minutes prior to injection. Unfortunately, it is not wise to use shots of local anesthetic when using fillers. Anesthetic shots makes it difficult to distinguish the volume that is from the anesthetic and the volume that is from the filler.

Héctor Durán, MD - Account Suspended · Answer

There is a new generation of fillers with lidocaine mixed, so this problem is already solved. Ask your surgeon for this kind of fillers.

Can local anesthetic (lidocaine, etc.) be used before injection of upper eyelid (i.e. orbital rim) filler? (photo)

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