Five percent lidocaine cream applied simultaneously to the skin and mucosa of the lips creates excellent anesthesia for filler injections.

BACKGROUND Injection of filler substances into the lips is painful, and many patients also find the injection of local or regional anesthesia into the lips painful. OBJECTIVE To develop a highly effective and painless form of anesthesia to facilitate injection of filler substances into the lips. METHODS Five percent lidocaine cream was applied simultaneously to the skin, vermilion, and mucosa of the lips (with the use of a barrier to keep the cream in contact with the mucosa and out of the rest of the mouth) for 20 to 30 minutes. RESULTS Profound anesthesia of the lips was reliably produced, with no complications. CONCLUSIONS This "anesthetic cream block" is easier to perform and better tolerated than injectable anesthetics. Use of this technique is likely to expand the range of physicians who perform filler injections on the lips and will probably also expand the range of patients who wish to have filler injections done on their lips and who (because they had little or no discomfort) are willing to return for additional filler injections in the future.