Patient Preference for Preprocedural Anesthetic Prior to Facial Cosmetic Injectable Fillers

Abstract

This study was designed to compare 2 common techniques for anesthesia prior to facial filler injections to determine which anesthetic method resulted in less pain during filler injections and which was preferred for future treatments. Via a randomized, prospective, split-face design, one side was treated with topical lidocaine gel and the contralateral received nerve block injection(s) to the infraorbital and/or mental nerve with local anesthetic. Hyaluronic acid (HA) filler was used to treat cosmetic deformities of the nasolabial folds, upper, and/or lower lips. Patients were surveyed to quantify the subjective pain during (1) preprocedural anesthesia and (2) injection of HA filler. At 1 week, patients reported which side was perceived as less painful, and his or her future treatment preference. Forty-eight participants (46 women and 2 men) were enrolled. In all, 77% perceived the filler injections with anesthetic block(s) as less painful, 21% recorded injections on the side pretreated with topical anesthesia as less painful, and 2% perceived no difference. Of all participants, 56% preferred local anesthetic injections for future treatments, 33% chose topical anesthesia, and 10% (5 of 48) had no preference. Patients rated the treatment of HA injections after anesthetic block(s) as the least painful method. Although more than half of the patients preferred this modality, the posttreatment survey suggests that there may be other factors contributing to patients’ preferences.