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POSTED UNDER Restylane REVIEWS

Scary Dental Block Reaction Prior to Restylane (Third Time) - Massachusetts

ORIGINAL POST

I went to the same Doctor for the 3rd time (no...

KGBJuly 17, 2009
$599

I went to the same Doctor for the 3rd time (no prior problems) to have Restylane injected into my upper lip. I received a Dental Block (lidojust as I had before, but this time it was then injected the other side of my face, which was also way painful than usual, though not quite as bad as the left side. When I complained of excruciating pain, he gave me a shot of saline and that did help the pain subside. However, I immediately swelled in my cheeks, and we did not do the Restylane.

He thinks I had a reaction to the preservative in the lidocaine. I am skeptical because I have never had a problem with lidocaine in my life, and have had plenty of dental work, etc. The next day my face was so swollen and completely numb that I could barely smile, and I could not feel anything. I had this in late March, and it is July and I am just now completely back to normal.

The swelling lasted about 2 weeks (the worst of it gone after one week), but my smile was partially paralyzed for weeks and I did not regain total feeling for months! It was terrifying.

I went to a few neurologists and plastic surgeons to get their opinions and they seemed to think that it was injected directly into the nerve (a fluke accident, not necessarily the doctor's fault). My friend is a dentist and he said no one is allergic to lidocaine. I'm not sure it was injected into a nerve because the saline dilution injection did help, and all the doctors said it was unlikely that he would hit a nerve on both sides. However, it was excruciatingly painful, and upon the first injection (on the left inside of my upper-lip, below the cheek) the pain went shooting all the way up to my left eye, in a fluttering sensation.


KGB's provider

George Hricko, MD (retired)

George Hricko, MD (retired)

Board Certified Plastic Surgeon

KGB rating for Dr. Hricko:

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Replies (27)

t37352
July 19, 2009
You are such a beautiful Girl, you really are! But I think you are making to many excuses for your Doc....he messed up...do not got back there... ever!
KGB
July 20, 2009
Thank you for the kind words. I'm just really confused as to what happened, and a lot of other doctors stood up for him. I'm obviously feeling bad about being vain enough to have had it done in the first place, but now I'm afraid to even have novacaine at the dentist!
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sallen
July 21, 2009
Most likely injection into nerve canal which is rare but can happen and can result in a numbness but should not effect ability to smile. This is confusing if you have true muscle activity decreased. The nerve injury will almost always resolve slowly over months but should not be permanent. Not sure i agree with above comment as this can happen even to very experienced dermatologists and plastic surgeons. Everyone has different anatomy, no one is just like the textbooks. I would guess you are fully recovered. There is preservative free lidocaine that can be used if needed. The extreme pain on injection is usually due to hitting the nerve directly with the needle so again, likely to be a rare event. go see an allergist to be tested for lidocaine allergy. Easy to do and will resolve the question. good luck
KGB
July 22, 2009
Thank you very much for answering and your input. I do believe this was a freak thing and not the necessarily doctor's fault, which is why I didn't take legal action despite what my friends told me to do. I had this procedure done by the same doctor 2x before with great results on the same lidocaine. Do you think it's possible I developed an allergy to lidocaine (or the preservative) out of the blue or would you say it is likely that he hit a nerve? I am back to normal now, but it took about 3-4 months to fully recover.
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sallen
July 30, 2009
Great to hear you are normal again.. This is always the case... It is highly unlikely you developed the allergy but a test in an allergist office will settle this issue for you so you can do more injections/biopsies/numbing as needed. Good luck
KGB
October 30, 2009
Hi Dr. Allen I met with another plastic surgeon yesterday, just trying to get as many opinions as possible, and he agreed with you that it should not have affected my ability to smile or move my lips (for example to suck through a straw) which it absolutely did. It was bordering on partial paralysis along with numbness for nearly 2 months. Do you have any idea what could have caused this? I know it is directly related to this injection of lidocain, as I have never had any problems with motor skills/muscle activity before. Thanks again for your time!
joyce589
February 13, 2011
Dear Dr. Allen,
I've been online searching for some possible hope for me, and the web brought your reply to the question above. I, like this young woman, had an injection of lidocaine w/ epinephrine, preceding injections, of what I was told, was Revanesse, to my upper lip only. The next day, and every day since, now 2 weeks, I have been unable to articulate words, especially p's, f's, b's, digraphs, etc. The doc said that I have motor nerve damage, probably due to MY reaction to the lidocaine w/E. I think that she accidentally, of course, hit a motor nerve with the needle. She says there is nothing that she can do. I'm on a 2nd Medrol pak with no improvement. I am devastated, insecure, and afraid. Very self-conscious of my speech....good lesson in humility. How long do you think this will last, and what can I do, in the meantime?
dancer
July 26, 2009
First of all, you are pretty & have a sweet smile and if you never got better, which you will,you'd still look pretty! Second, as someone who has had Bell's Palsy and a paralyzed face and residual partial paralysis, meaning I NEVER got my normal smile back, & one eye is slightly smaller than the other, I KNOW WHAT YOU MEAN BY SCARY, I HAVE BEEN THERE SEVERAL TIMES, AND NOTHING IS WORTH THE RISK YOU ARE TAKING.THIS IS YOUR FACE YOU'RE TALKING ABOUT. I WOULN'T LEAVE THE HOUSE FOR MONTHS, OF COURSE I LOOKED ALOT WORSE THAN YOU, YOU LOOK FINE, BUT DON'T PUSH YOUR LUCK.YOU STILL LOOK GOOD, SO KEEP IT THAT WAY. Also, I had a problem with a dr. & also said I believed he was a good dr.NOT HIS FAULT, and blah blah. LISTEN TO ME, WHEN SOMETHING LIKE THIS HAPPENS, IT IS THE DR's FAULT. SORRY DR. ALLEN, WHAT ELSE WOULD YOU SAY, AS A DR.? We know everyone is different and it's your job to know how to inject on each different person.However, One dr explained to me that we have nerve canals & some people's are smaller than others so that when the nerve swells as mine did and as I think your's did, there's no room in the smaller canal for the enlarged nerve & thus the resulting paralysis in only some people. KGB, here's my advice and coming from me, with five previous episodes of facial paralysis from the Bell's, I think I know about facial problems and how scary they are and how we take our beauty for granted. I lost my beautiful smile which greatly affected me - DON'T TAKE A CHANCE ON LOSING YOURS. First, can't go back to same dr., no way. Second, why would you get a painful shot of lidocaine and then more painful shots of restylane? if you must get the lip shots, and I don't think you should, DON'T GET THE LIDOCAINE. THEY HURT ANYWAY, SO JUST GET THE PAIN FROM THE RESTYLANE AND FORGET IT. YOU'RE HAVING PAIN FROM THE PREVENTIVE SHOTS SO WHAT'S THE POINT? AND YOU KNOW YOU WILL NEVER BE ABLE TO GET THE LIDOCAINE AGAIN WITHOUT PANIC AND FEAR, RIGHTFULLY. ALSO, WITH ALL THE TOPICAL PRODUCTS ON THE MARKET FOR LIP PLUMPING, FORGET THIS AND GET SOME FUSION LIP PRODUCTS, THEY DO THE TRICK. SO DOES ADRIAN ARPEL LIP PLUMPING CAPSULES. Put on at nite, have plumper lips a.m. not the same as restylane, but hey, NO RISK. what you're doing IS TOO RISKY. IT'S TOO LATE TO EVER GET MY SMILE BACK B/C THE MUSCLES ATROPHY VERY QUICKLY, BUT YOU'RE STILL OKAY, DON'T RISK IT AGAIN, PLEASE. DDS EVEN TOLD ME INJECTION WAY BACK IN MOLAR AREA CAN CAUSE FACIAL PARALYSIS B/C THEY DO GO INTO THE NERVE. I EVEN TRY TO AVOID THAT, LETTING THOSE TEETH GO. I LIVE IN CONSTANT FEAR OF GETTING THIS AGAIN AND YOU'RE JUST ASKING FOR IT. YOUR FACE IS NOTHING TO FOOL AROUND WITH. I HOPE I'M GETTING THRU TO YOU. :) BE WELL.
2935anon
November 4, 2011
Hi, I just happened to read your email. Doing research as well. So sorry to hear about all your issues will Bells Palsy :(. Don't know if you are aware but there is a facial paralysis specialist in LA that may be able to help you (can't hurt to check out his website). His name is Babak Azzizadeh and he has a paralysis clinic. He worked on Betty Jo Buttafucco (spelling ?) and she looks pretty good :)
dancer
July 26, 2009
KGB, ONE MORE THING. If it was a reaction to lidocaine and you need an allergy dr. as Dr. Allen suggests, then why didn't you have this problem from the beginning? I KNOW WHY, IT'S B/C YOU'RE NOT ALLERGIC TO IT. HE DID THE OTHER INJECTIONS PROPERLY AND SCREWED UP SOMEHOW ON THIS LAST ONE. You said yourself it hurt worse and then you had this reaction FOR THE FIRST TIME. DON'T GO BACK, AND DON'T GET LIDOCAINE FOR THESE PROCEDURES AGAIN. SOMEONE ELSE COULD DO THE SAME THING AND YOU MAY ALSO VERY WELL HAVE SMALLER NERVE CANALS AS I SAID IN PREVIOUS COMMENT, THEREBY MAKING THE SHOTS EVEN MORE RISKY FOR YOU.
KGB
July 27, 2009
Thank you. I'm sorry you experienced a similar thing. That must be horrible for you. Will yours not resolve at all in time?
dancer
July 28, 2009
No, unfortunately, even tho the nerves take longer to rejuvenate than any other body part, if they don't come back within one to two months, they're not going to. My bigger problem is really just living with the fear that it's coming again and what will I be left with. As I said,I had it about five times, full blown, and other smaller episodes that resolved with meds.but why is the question that no one can answer. But havng to live with this is what makes me so sure that you shouldn't take chances with your face. Believe me I know no one thinks it can happen to them, but so did I and yet it did. I have fear just going to the dds and hearing myself say this makes me wonder how i ever did the restylane at all, but mainly I did it to fix the pull from Bells and it actually did, thank God. I never realized it could have made it worse if it hit a nerve. Okay, I can only hope you take my advice. Good luck.
UPDATED FROM KGB

 **UPDATE** I am fully recovered, and I...

KGBOctober 28, 2009

 **UPDATE** I am fully recovered, and I recently ran into the Doctor who did this, at a restaurant in town (we were both getting take-out), and he looked as if he had seen a ghost when he saw me.  He was very uncomfortable, very awkward, and VERY quick to get out of my sight.  I had to be the one to say "hi", and I did because I couldn't believe he was going to ignore me after looking me in the eye.  He did not forget me, as I was in there once a week after this happened so they could monitor what was going on with my frozen, swollen face,  I needed to say something to get him to acknowledge me, and so I said  "I'm all healed".  He said "oh good", very nervously, and rushed out.  It was very dismissive.  It angered me because I could have sued him -- I think most people would have and I was even advised to, but I didn't because I figured anyone can hit a nerve, it wasn't intentional.  I felt very brushed off and that he was very sleazy.  I will name him now, after all this time trying to be respectful of him and his practice, but he doesn't care about me at all, I believe he was only trying to protect himself from getting sued.  

I want to know what other doctors think this could be, and if anyone else has had a similar experience.

Replies (17)

philly pa
January 5, 2011
This sounds familiar. I had a crazy rittenhouse square dentist screw up, big time, an anesthetic injection in my mouth near the back teeth along the jaw line. It hurt like hell and I had to grab her hand because she was ignoring my groans and body language.

I could not open my mouth, without intense pain, for about 4-5 months.

I figure that no one is perfect and crazy me I went back to her again and she gave me this freaky, weird diatribe, psycho passive aggressive, directed against me but talking about aggressive middle aged women! I should have sued her ass.
Opal33
February 5, 2011
I wouldn't listen to that "dancer" person. I'm not a doctor, but I do know that sometimes, even in the best hands, things can go wrong. Nobody's anatomy is exactly like somebody else's and it truly may not have been the doctor's fault. It's also true that almost nobody is allergic to lidocaine, which is why they use it and not older, less safe products. The long-term tingling sounds like something that happens when a nerve is CUT; I had the same thing occur after my brow lift. However, it doesn't make sense that it would happen on both sides.

I do think it's possible that you had a problem with the preservative in the anesthetic. The fact that you never had a reaction before doesn't mean that you never will. It's possible to take a drug all the time, and suddenly develop an allergy. I would go see the allergist, and try preservative-free lidocaine from now on.

You may just have some kind of physical issue that means you shouldn't have nerve blocks in this area. "Lip plumpers" don't work the same way that injectibles will, and you'll never have the same result. They simply irritate the skin and make it swell. I'd go get that second opinion, and lay off the injections, but I don't think it sounds, to me, like anybody screwed something up.
joyce589
February 13, 2011
Hi,
I just mistakenly wrote my reply to Dr. Allen above, who helped KGB, instead of here,at the end of the comments. So I will ask it again. I had lidocaine with epinephrine injected into my mouth area, followed by what I was told, was Revanesse, 2 weeks ago. I am miserable, and frightened. I cannot pronounce p's. f's, v's, and consonants put together, like "th" etc. The doc said I have nerve damage, but it was due to MY reaction to the lidocaine with E. I think, of course, that she hit a motor nerve with the needle. My biggest fear is how long this could last. My life is at a screeching halt, as I'm so insecure to talk, and my mouth looks funny and distorted when I do. Is there anything at all that can be done to speed up this recovery? I know nerve damage takes awhile to heal.
KGB
February 15, 2011
Hi Joyce
I was terrified, as you can see from the pictures I was totally distorted, but I was back to normal about 2-3 months later, thank god. I would recommend seeing a neurologist or a facial plastic surgeon specializing in nerve damage- just so see if they think you have nerve damage that will heal on its own - which it likely will. Very scary, but it should go away gradually.
Las Vegas5059
February 15, 2011
Had Restylane injections 3 years ago, along with Botox and I loved the result. I had deep jowls and it completely got rid of them and they've still never come back as deep as they were. I will do it again this year, unless I opt for a facelift (Lifestyle Lift) instead.
Dr Czapla
February 23, 2011
Hello, I have practiced dentistry for over 24 years now and from what I have read in this discussion is that the injection was actually given into a blood vessel causing the excruciating pain. Very often the Lidocaine has epinephrine added to it to lengthen the duration of the anesthetic. However, if injected into a blood vessel it triggers an epinephrine cascade in the vessel, feels like fire and is very painful. Additionally an injection hematoma occurs and the vessel swells causing more prolonged pain and discomfort. When an injection is given we aspirate, meaning to draw back on the syringe, to make sure that we are not in a vessel. This does take time to resolve itself, and looks like what had occurred along your timeline. Cold packs initially and sometimes placing the patient on a Medrol dose pack relieves the swelling and symptoms. If the injection were into a nerve you would know it at that very instant and I am sure that the doctor would have moved the needle to aleviate the pain. This does not sound like an allergy to lidocaine or even a preservative in the anesthetic since you have been injected with this before. It sounds like a poorly placed injection.
KGB
March 2, 2011
Thank you so much. This is very helpful. I just took down pictures of my partial paralysis, but if you think it would help, I would repost them.
Dr Czapla
March 3, 2011
No need to repost the pictures. I'm sure that most all of your symptoms have disappeared by now and you are not in any pain presently. I hope all is well.
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