Will lip fillers have a tolerable pain level if I go without lidocaine?

Hi there! Yes, you can absolutely go without lidocaine topical application. It may be a bit more painful, but I do have patients proceed this way. I will often employ ice additionally to help ease the discomfort. It's worth noting, though, that many of the fillers still have lidocaine in them, but should stay locally. Hope that helps!

We generally use numbing cream for lip fillers. For some we may also recommend Pronox which is inhaled to help the patient feel calmer. Tapping is yet another method we use to help with discomfort during injections. I've included a video on this that I hope you find helpful.

Many fillers have lidocaine in them so the injections become a little easier throughout the process. It is fairly common for people not to use numbing cream for lip fillers. Of course having any injections in the lips is not painless, but tolerated well. They will feel sharp, but very fast and short lived.

I would recommend going somewhere that does a dental block (lidocaine injection) for lip fillers. That way you can have the numbing of your lips while not affecting your mouth or throat. Lips have more nerve endings per square centimeter than almost any other area of the body and can be very sensitive so I would not recommend having lip fillers without any numbing medication.

Each provider will have their own protocol or ways of doing lip fillers. Some people use ice most use topical local anesthesia.
You can also place the topical anesthesia on the outside dry part of the lip avoiding getting it in the mouth. You can also put gauze between the lips which will keep the numbing cream from getting in your mouth. It’s simply just a matter of using good technique.
Personally my preference is always been to inject the lips with local anesthesia with increased concentrations of both lidocaine and Epinephrine using very small doses.
I typically start by adding topical anesthesia let that stay on for about 20 minutes then very very slowly inject tiny amounts of 2% lidocaine with a ratio of 1 to 25,000 Epinephrine. And then typically wait 10 to 15 minutes and this causes extreme vasoconstriction of the lips blanching them so they’re almost white. with the lips fully numb and fully basal constricted the patient is unlikely to have any bleeding no matter how many times you inject and will have zero pain with the injection. This allows me to carefully inject small amounts show the patient and continue back-and-forth until the result is perfect and consistent with what the patient requests. I always ask the patient to give me input in regards to overall volume symmetry etc.
Because there’s literally no pain once the lip is numb and there’s no or minimal chance of bruising with multiple needlesticks this becomes possible and the results become very consistent with minimal chance of bruising and after the local anesthesia it’s a painless procedure.
After years of trying different techniques this is what I found to be by far the best way of doing it.
Not a lot of providers are willing to spend the time or have the knowledge of how to do this correctly. A dental block is not the same because it doesn’t give the vasoconstriction that injecting directly into the lips does. The key to injecting local anesthesia is to go as absolutely slow as possible. The slower the injection is done the less pain there is and if the surgeon is willing to take their time the injection of lidocaine should be very very comfortable.
I suggest you talk with your provider about various options or try finding another provider.
Lips are exquisitely sensitive and is one of the most vascular parts of the body. Multiple needlesticks increases the chance of bruising and swelling and without any anesthesia you should expect the procedure to be uncomfortable.
I’ve done lip fillers with every different possible way in regards to anesthesia and explained what my preferred method has been.
Different people have a different level of comfort with procedures. Lip fillers are notorious for being a bit uncomfortable and a pretty high risk procedure for bruising. Local anesthesia typically has some vasoconstrictive agents in it which help decreased bleeding and minimize bruising.
The key with this as it is with all aspects of cosmetic surgery is to find the best provider.
Best,
Mats Hagstrom MD