When It Comes to Lips, Does Pretty Have to Hurt?

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Editor's note: This blog post was written by Bonnie Marting, DNP, ARNP, who practices at Anushka Cosmedical Centre in Jupiter, Fla.
With the FDA approval of Restylane for lip enhancement and the anticipated direct-to-consumer marketing from Medicis, those of us in dermatology and aesthetics will undoubtedly receive more inquiries about this procedure and of course the ubiquitous question: "Does it hurt?" Well, it could. But it doesn't have to.
I frequently hear stories about past lip experiences in which "It hurt so much I had to ask them to stop!" Not being a fan of pain myself, I often wonder why a practitioner would not give the patient a choice. In my fairly large practice, I have one patient who doesn't want anything for pain control. Not even ice. I have another who will use the ice but no anesthetic. About 40% will take the topical anesthetic, and the rest are very happy to have a dental block, even if it persists for a while. I have found that more and more patients opt for the topical since the hyaluronic acids now contain lidocaine. But to use nothing? The time saved does not outweigh the critical patient experience, even if they loved the result once the pain dissipated.
One caveat, however, is to remember that some blocks can cause swelling, distorting the target. Moving fairly quickly when using a block facilitates the positive patient perception and results in everyone being happy.