New types of fillers have hit the market lately. What differentiates them is that they contain local anesthesia, which is supposed to make filler injections less painful. Dr. Schultz discusses these new types of fillers with anesthesia and the mer...
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Hello. I’m Dr. Neal Schultz and welcome to DermTV. Fillers are a fast and easy way to correct all sorts of facial contour defects whether they’re lines, wrinkles, creases—but their main drawback is that they are not painless. There is some real discomfort. So anything that we can do to make this experience less uncomfortable makes it better for the patient. Recently, filler manufacturers have started adding local anesthetic right into the material of the filler to help to decrease the pain and interestingly, a lot of my patients tell me that fillers with local anesthesia actually hurt much less than fillers without them. Now, I never argue with success and I think that that’s really great but I have to tell you quite frankly, I don’t understand why filler with local anesthesia makes it less uncomfortable. And let me explain. There are two parts to the event of having a filler treatment that cause discomfort. The first is the insertion of the needle actually through the skin. Let me show you what I mean. I’m going to take the syringe with the needle and I push it through the skin. That needle has punctured the skin and it doesn’t matter what’s in the filler. It doesn’t matter whether local anesthesia there or not because that discomfort was caused just by the needle pricking the skin. Of course, topical anesthetics like EMLA put on the skin for 20 minutes before the treatment can help decrease that discomfort. But after the needle has gone through the skin, the second part of the discomfort actually comes for the infusion of the filler into the skin. Let me show you what happens when I push on the syringe. As you can see, there is white material coming out. This is the filler and it actually forms a volume in the skin. It re-expands that skin because it’s the collapsing of the skin that has caused lines and wrinkles and creases. And by re-expanding that, it makes the skin smooth. Well, when you stretch the skin back to where it should be, you also stretch nerves. And when you stretch nerves, you fire them and that’s what causes the pain. We know that local anesthetic usually takes a few seconds to work to make your skin number. But the expansion of the skin from the insertion of the material happens instantaneously yet people don’t have any discomfort despite the fact there’s been no time for the local anesthetic to work. This is the bottom line, patients tell me it works. Patients tell me that it’s less uncomfortable. So the next time you go for a filler treatment, ask your doctor if your doctor has fillers with local anesthesia. Please join me again at DermTV.com. If you have a question, please send it to me by visiting DermTV.com/question. I’m Dr. Neal Schultz and thank you for watching today.

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