New techniques decrease discomfort and bruising from filler injections

For many years fillers have been injected with a syringe and multiple sticks with a small sharp needle.  This was moderately uncomfortable but relatively quick, taking 5-10 minutes. The only way to decrease discomfort was to apply numbing cream or do nerve blocks.  Numbing cream is messy and needs to be applied 30-60 minutes prior to the injection.  The affect is variable and even at its best does not eliminate much pain for most patients.  Nerve blocks, injecting regional nerves with novocaine, need to be performed 5-10 minutes before the filler injection. Most patients find doing the nerve block itself hurts more than the actual injection of filler.  Both of the techniques can distort the tissue, making it more difficult for the physician to determine the amount and location of filler injection.

A number of years ago most filler manufacturers started adding numbing medicine (xylocaine)  to their filler.  This decreases discomfort quite a bit, but the first few needle pricks can still be felt. The numbing medicine definitely helps when the physician has to make 2nd and 3rd injections in the same spot, which is not uncommon.  Patients tell me they greatly prefer the filler with the numbing medicine.

The latest advance for filler injection is the “blunt needle” technique.  There is no question that this technique also significantly decreases discomfort and minimizes the risk of bruising.  Only 2-4 very quick pinches are required.  A tiny blunt tipped needle  is threaded under the skin to deposit the filler. Because the needle is rounded at the end, not sharp, it slides around blood vessels and nerves and causes less tissue trauma than a sharp tipped needle.  Discomfort is minimal and the risk of bruising is decreased. This technique is great for injecting the lip, which is an extremely sensitive area.  It can also be used for cheeks, marionette lines, eyelids, and other areas of the face.  Most fillers can be injected with this method, but blunt injection can not be used when the filler needs to be injected very superficially.

In my office, I use fillers with numbing medicine and the blunt needle technique whenever possible.  Although we have not eliminated discomfort, it is much easier today have fillers with these newer techniques.

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