In addition to the above topical techniques, I take advantage of predictable facial anatomy to selectively anesthetize nerves that supply sensation to specific regions of the face. I use a tiny amount of local anesthesia injected within the vicinity of these nerves to generate broad numbness in the treatment area for the duration I need to place the filler. Performing these regional blocks also prevents the distortion of the treatment area with local anesthesia, which would make it difficult to achieve good aesthetic results.

For example, I perform regional anesthesia prior to placement of hyaluronic acid filler in the lips. The lips are a very sensitive area of the body. However, injection of filler here need not be painful. There are two (2) pairs of nerves that supply most sensation to the lips. The first, the infra-orbital nerves, exit from the cheeks to the side of the nose and supply sensation to the upper lip. The second, the mental nerves, exit the jaw above and on either side of the chin and supply the sensation to the lower lip. Careful placement of local anesthesia to these locations can anesthetize the upper and lower lip in the areas where hyaluronic acid filler needs to be placed.