A variety of injectable fillers now exist for the treatment of facial folds and deep lines as well as enlargement of the size of the lips. While many of the injectable fillers are different and last varying lengths of time after injection, there is no question about their immediate satisfying results. Despite the instantenous results that they create, many patients fear (understandably) the actual injection process. No matter how you look at it, the sticking of a needle into very sensitive facial areas can certainly give one pause for thought.
While it is true that most injectable fillers use very small needles (typically 30 gauge, the smallest needle made by mass manufacture methods), they will cause some discomfort. I have found that some patients, remarkably, tolerate injections with little discomfort while others experience significant discomfort. Given that no injectable filler is permanent, meaning one injection for life, the need for repeat injection treatments is necessary. Since repeated injections are necessary, I feel that the recurrent needling experience be as comfortable as possible.
Many pain-reducing methods are available for facial injections such as ice application, numbing creams, and numbing agents in the injectable fillers themselves. I have not found, however, that most of these commonly and easily used methods to be particularly effective. I routinuely use nerve blocks which can quickly be done and are far more effective. Nerve blocks, also known as dental blocks, are injections done from the inside of the mouth. When doing such nerve injections, what you are really after is where the big sensory branches of the trigeminal nerve exits from the jaw bones. For the upper lip and nasolabial (cheek-lip grrooves) folds, the nerve comes out through a bone hole immediately underneath the eyebone. (infraorbital nerve) For the lower lip, the nerve (mental nerve) comes out between the first and second bicuspid teeth of the lower jaw. A few tenths of a ccs. of plain lidocaine, which wears off in less than 30 minutes, will make most of the planned injection area go numb.
While many patients fear a ‘dental injection’, it can be minimally uncomfortable if done well. Besides… one small needle stick is better than many needle sticks that are usually needed for most injectable facial filler treatments.
Dr. Barry Eppley
Indianapolis, Indiana