Hi, Thank you for your question. In our practice, we apply numbing cream to the lips with occlusion, for 30 - 45 minutes prior to injection. In the vast majority of cases, this is sufficient to make the injections quite tolerable. However, there are some patients who have a low pain tolerance and in those cases, I will perform a facial block prior to the injections. The middle of the upper lip has a separate innervation apart from the rest of the upper lip so in some cases, I will inject a small amount of local anesthetic there, which makes the injection much more comfortable. I have patients that routinely return to the clinic for a refresh of their lip filler periodically so they appear to think that the discomfort of the filler is worth it! Hope that this helps. Good luck.