While many patients enjoy the benefits of injectable fillers into the lips, they do not look forward to the experience of getting it. No matter how it is conventionally done, there is going to be pain involved. While I have a few patients who prefer to take it ‘straight’ (no form of anesthesia), they are the exception. Most of the time I use dental injections, which if skillfully placed, can make the lip injection experience near painless. (other than the intraoral blocks)
But the use of dental blocks does not decrease the risk of bruising from lip injections as a sharp needle, small as it may be, can still cut blood vessels. And a bruise in the lips, even though it is innocuous and will eventually go away, is a visible reminder for a week or so that one has had lip injections.
The use of microcannulas has changed all of these lip injection issues and risks. With a blunt-tipped introducer rather than a sharp needle, the risk of bruising is virtually eliminated and pain is dramatically reduced. In addition, by using a single pass on microcannula withdrawal the issue of lumpiness and asymmetry is much less likely with a more even linear deposition of the filler material across the lip.
But the use of microcannulas in the lips is not perfectly pain-free. A small needle stick must be done to allow the microcannula to pass into the lip. I prefer to put a small drop of local anesthetic into the skin just outside the corner of the mouth or directly into the corner itself. This will then allow for comfortable making the needle stick and passing the microcannula in and out as much as one needs. Almost all patients will feel the pressure of the microcannula as it passes through the lip but this is not usually reported as pain.
Injectable filler treatment of the lips will never be a completely pain-free experience. But the use of microcannulas make it about as close as it can be.
Dr. Barry Eppley
Indianapolis, Indiana