Hi All-

Quick poll - what is everyone's favorite topical anesthesia? I have used both BLT and betacaine, and both are great for botox, fair for fillers, and inadequate for lips (need blocks).

Any others that people like?

Thanks.

I always use blocks for lips and fillers. I use a cobination of blocks plus a compounded topical of 23% lidocaine and 7% prilocaine for Fraxel and deeper resurfacing. Make sure to not get carried away as you could end up with lidocaine toxicity. I do not use anything for Botox. I use a 31g needle and occasionally will use ice.

I mix about 0.25 cc 2% Lido with epi into the syringes of Radiesse, Restylane, Juvederm, and Perlane with great success. It has significantly reduced the amount of pain and I no longer have to use topical agents when doing fillers at all (although I do use ice packs immediately prior to injecting). I still do dental blocks or modified dental blocks if I'm going to fill the lips, but for filling anywhere else people don't even wince anymore now that we're mixing them with Lido. I would now never inject fillers again without mixing. (to mix we use a separate syringe connected to the filler syringe by a "Baxa Sterile Rapid-Fill Connector Luer Lock-to-Leur Lock"). (Also, Radiesse cannot be stored for more than one to two days after being mixed with Lidocaine, as opposed to the hyaluronic acids, which I usually keep for two weeks until a patient's touch-up or re-check appointment).

Pliaglis .

lsipo,

How much per treament id the pliaglis costing. The numbers I came up with was about $60. I refuse to pay that much.

LH,
yeah its 60.00 per tube/ 30 grams - doctor cost. It was the cream dr. tina alster has been working on for past year. We use it during resurfacing procedures works well. Still some discomfort. You can do about 2 faces per tube. Our office is going with it mainly for FDA indications and clearance. I personally like when you can peel it from the eye lids, blt can get real messy....

For fillers in the NLF or lips, I use mucosal or nerve blocks. First I use 20% benzocaine on the mucosa for one minute before injecting 2% lidocaine without epi.

For Botox, I use a very small BD 31 gauge needle, so I do not use numbbing. However, if the patient is very nervous, I will use the Zimmer Cooler for botox, letting the pt hold it and aim it. This makes them feel in control and distracts them.

I am having terrible results with Pliaglis. I think I'll stick with a BLT. bcm09

What about BLT for a brestfeeding woman?

Benzocaine is Preg Cat C

Lido and Tetra are Cat B

I have to ask. What procedure are you doing on pregnant women?

LH

I don't know if you are asking me or kb. As for me nothing cosmetic, but I know this from working the ER.

Florida PA,

I was asking you. I avoid pregnant women at all cost except for LHR. I will not do any LHR anywhere near the abdomen or genitals while pregnant. Through the years I have had too many women that have a miscairage and are looking for a reason. They will blame themselves for the 2 tylenol they took a day before they found out they were pregnant. So if you did any procedures on them while they were pregnant they may be looking at you as the cause.

So my recommendation is to avoid pregnant women and be very cautious with breast feeding women.

According to Tony PA-C, your idea is really cool and interested. However,what u have meant by "Baxa Sterile Rapid-Fill Connector Luer Lock-to-Leur Lock" is 3-way connector or not??

If not, please kindly explain or illustrate for us to give us an image on what you have done.

Really impressed on your technique.

According to Tony PA-C, your idea is really cool and interested. However,what u have meant by "Baxa Sterile Rapid-Fill Connector Luer Lock-to-Leur Lock" is 3-way connector or not??

If not, please kindly explain or illustrate for us to give us an image on what you have done.

Really impressed on your technique.

According to Tony PA-C, your idea is really cool and interested. However,what u have meant by "Baxa Sterile Rapid-Fill Connector Luer Lock-to-Leur Lock" is 3-way connector or not??

If not, please kindly explain or illustrate for us to give us an image on what you have done.

Really impressed on your technique.

What do some use open filler for weeks on end? Every manufacturer (Bioform, Allergan, Medicis) intend their products for single use. If your patient ever gets an infection you would never be able to protect yourself legally. How is an open syringe sterile after opening it and then waiting two weeks? Very unsanitary whether you recap it with a rubber stopper, attach a needle. Seems like terrible advice for anyone to give by anyone in the medical field. It is an example of bad practices being taught.

What do some use open filler for weeks on end? Every manufacturer (Bioform, Allergan, Medicis) intend their products for single use. If your patient ever gets an infection you would never be able to protect yourself legally. How is an open syringe sterile after opening it and then waiting two weeks? Very unsanitary whether you recap it with a rubber stopper, attach a needle. Seems like terrible advice for anyone to give by anyone in the medical field. It is an example of bad practices being taught.

What do some use open filler for weeks on end? Every manufacturer (Bioform, Allergan, Medicis) intend their products for single use. If your patient ever gets an infection you would never be able to protect yourself legally. How is an open syringe sterile after opening it and then waiting two weeks? Very unsanitary whether you recap it with a rubber stopper, attach a needle. Seems like terrible advice for anyone to give by anyone in the medical field. It is an example of bad practices being taught.

What do some use open filler for weeks on end? Every manufacturer (Bioform, Allergan, Medicis) intend their products for single use. If your patient ever gets an infection you would never be able to protect yourself legally. How is an open syringe sterile after opening it and then waiting two weeks? Very unsanitary whether you recap it with a rubber stopper, attach a needle. Seems like terrible advice for anyone to give by anyone in the medical field. It is an example of bad practices being taught.

What do some use open filler for weeks on end? Every manufacturer (Bioform, Allergan, Medicis) intend their products for single use. If your patient ever gets an infection you would never be able to protect yourself legally. How is an open syringe sterile after opening it and then waiting two weeks? Very unsanitary whether you recap it with a rubber stopper, attach a needle. Seems like terrible advice for anyone to give by anyone in the medical field. It is an example of bad practices being taught.