I'd like to get lip Injections but my pain tolerance is super low, any suggestions to help with the pain?

Question

Hi doctors! My name is Jennifer and my pain tolerance is extremely low! I'm super sensitive to needles and I tend to get really nervous and scared! I live in Los Angeles and I'm looking for a doctor who can make me feel really comfortable about getting my lips done and someone who can literally numb everything, whether I have to use a numbing cream, and a topical anesthetic. Please let me know what I can do and who I can see.

David Hansen, MD · Answer

My patients are so happy with lip injections because I do the nerve blocks to numb up the lips painlessly.  You don't have to worry about being scared and in any pain at all.  It is very easy and comfortable to get done.  Sincerely,

	David Hansen,MD

Michael Kulick, MD, DDS · Answer

HI Jennifer - your concern regarding the pain associated with in office, lip augmentation is not abnormal. There are topical anesthetic creams, cooling agents but what I have found to be the most helpful is the use of nitrous oxide, often called laughing gas. Dentists have used this for many years. Being a former dentist and understanding it's benefit, I knew how this technology could help my current patients with their concerns regarding pain and anxiety for in-office treatments, which include lip injections. 
Michael Kulick MD
   Board Certified Plastic Surgeon
   Member of ASPS, ASAPS
   Recipient of the Klingbeil Award – Teaching Safe Techniques and Advanced Technologies

Jason D. Bloom, MD, FACS · Answer

I have found that many patients in my practice are not excited about getting nerve blocks for pain control in lip augmentation because they are still injections. My technique now consists of topical lidocaine around the mouth before injection and then using a small blunt tip, microcannula to inject the entire lip (vermillion lip border, lip body, etc.). An entrance to the lip is created in at the corners (oral commissures) and the entire lip is able to be enhanced though 2 small needle holes. This has greatly reduced the pain and bruising for my patients.

Behrooz Torkian, MD · Answer

Hi Jennifer,

	Lip injections can be done painlessly with a series of nerve blocks to numb both the upper and lower lip completely.  The blocks are done after application of a topical anesthetic to the inside of the lip.  Then a small injection of local anesthetic is used in specific locations to get your lips numb, and within a few minutes you are ready to have fuller lips!

	This is very well tolerated and is usually very surprizing to the first-timer.

Tonya Boudreaux, MD · Answer

Lip injections do hurt! Luckily, if you go to a good and experienced Medical Spa or Cosmetic Surgeon, they will have the option of a dental block for you (just like at the dentist). This will make you feel much more comfortable and numb than just topical numbing cream. You will feel initial pinches from the injections from the dental block, but it is significantly LESS than you will feel with lip injections.
You can also ask your injector about using small syringes like insulin syringes to help with pain, bruising, and swelling. 
Definitely set yourself up with a consultation and find a nurse that makes you feel at ease and comfortable.
Best of luck from Gravity Med Spa!

Philip Young, MD · Answer

The two main ways to anesthetize the lips are to put topicals or carry out some regional nerve blocks.  You can also inject locally but this can obscure the anatomy and may get in the way with the results. Prior to doing the injections for the regional block you can use topicals and ice to further make it more comfortable. Also using something that can create some vibrations can also make the regional blocks even more tolerable.

Kimberly Lee, MD · Answer

Hi Jennifer! You are not alone! There are many advanced ways to address the pain with lip injections. In my office, we use a custom topical anesthetic to numb your lips. Combined with fillers that have additional local anesthetic in it already, this seems to be well tolerated without the need for local blocks. Occasionally, a local block may be needed, but the combination of topical and local anesthetic in the filler seems to do the trick. Of course, the skill of the injector is also important and he/she needs to do this with patience to minimize any discomfort. We want you to be comfortable during this process!

Edward J. Domanskis, MD (in memoriam) · Answer

Lip injections really hurt. I use Prevelle which is the only filler that I can inject through a very tiny/small caliber, needle. I can also apply a topical anesthetic and numb the lip but the latter sometimes hurts as much as the injections!

Francis R. Palmer, III, MD (retired) · Answer

We have been injecting fillers, in the lips, for over 20 years and IMHO topical numbing creams won't do the trick. You would need a full dental block that can be done by your dentist before your visit or here at our office. This is the only way, you'd be comfortable during the lip injections IMO.

James McMahan, MD (retired) · Answer

For patients who do not tolerate injections well, it is best to numb the lips before augmentation with injections as they are about the most tender area to treat. Unfortunately, things like ice and topical anesthetics are not generally adequate. Many of the injectables have a local anesthetic in them now, but even this is not usually adequate for the lips. It is relatively easy to numb the lips with a 'dental block' but it does require the use of fine needles.

I'd like to get lip Injections but my pain tolerance is super low, any suggestions to help with the pain?

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