Pain minimisation

There are many ways to make the patient experience more comfortable for cosmetic procedures.

Quick Facts

  • At The Victorian Cosmetic Institute, our goals are to minimise any discomfort from the procedures performed
  • The level of anaesthetic/analgesic used will depend on the type of procedure performed
  • We commonly use ice, local anaesthetic creams/injections, vibration, anaesthetic gas (nitrous oxide), and oral and intravenous anaesthetic/analgesics.

Why is anaesthesia/analgesia important for cosmetic procedures?

As most of the procedures performed at The Victorian Cosmetic Institute are elective, it is important to us that you feel little or no discomfort during your procedures.

Appropriate anaesthesia/analgesia will also ensure that you have a positive experience from your visit, and increase the likelihood of having the procedure again if required.

What types of anaesthesia/analgesia are there?

Anaesthesia is defined as the entire loss, partial loss or absence of feeling or sensation. There are varying forms of anaesthesia;
General anaesthesia – where complete consciousness is lost as well as loss of airway control, as used in hospital surgical procedures (we do not use general anaesthesia at The Victorian Cosmetic Institute)
Sedation – where there is partial consciousness, but no loss of airway control. Memory of the procedure may be hazy or non-existent. At The Victorian Cosmetic Institute, we may use oral medications or intravenous sedation or analgesics prior to treatments.
Local anaesthesia – which is injected into an area to cause a local area of numbness/anaesthesia. We commonly perform local anaesthetic nerve blocks which, if done properly, are not painful and can help to completely numb a certain area e.g the lips for lip enhancement.

Analgesia is the deadening or absence of a sense of pain without loss of consciousness.  Analgesia can be in the form of oral analgesia such as paracetamol, or injectable forms of analagesia.

Many of the medications used for anaesthesia have some analgesic properties and vice versa.

What types of anaesthesia/analgesia are used for non-surgical procedures?

Non-surgical procedures such as anti-wrinkle injections, dermal fillers, deeper chemical peels,  laser treatments, skin needling, liposuction, and plasma skin regeneration are all performed in our clinics. A general anaesthetic is not required as this is sometimes excessive for these procedures. Instead, the following modalities of anaesthesia/analgesia are used ;  
 
Ice – Both pain and temperature sensation travel in the same nerve pathway. If this nerve pathway is overloaded by the cold sensation of ice, pain is less likely to be felt in the same area. For example, your hands tend to feel numb when they are very cold. Ice can be used on the skin prior to anti-wrinkle injections and dermal fillers in particular.
 
Vibration – By using a vibrating device on the skin, the nerve pathway that conducts pain is overloaded by the vibrating stimulus and the pain signals do not pass through to the brain as easily.
 
Local anaesthetic cream – Local anaesthetic creams can be used on the skin to help to numb the skin prior to any injections. Again this can be used for anti-wrinkle injections, dermal fillers, prior to laser treatments, and prior to the use of local anaesthetic injections.
  
Local anaesthetic injections – Local anaesthetic injections can be used to numb a certain area. They can be injected directly into the skin, or around a nerve to block sensations of the areas of skin/tissue supplied by that nerve. Local anaesthetic injections are effective, but their application can cause some discomfort. Usually, these local anaesthetic injections are used when they are less painful than the actual procedure would be without them. Local anaesthetic cream or anaesthetic gas can be used prior to local anaesthetic injections to reduce the discomfort of the local anaesthetic injections. Local anaesthetic injections are commonly used prior to the application of dermal fillers, laser tattoo removal, skin needling, and plasma skin regeneration.

At The Victorian Cosmetic Institute, we use a computerised local anaesthetic delivery machine called ‘The Wand’. Designed for the dental industry, it is a cleverly engineered machine that delivers local anaesthetic extremely slowly to the area to be treated, then, any pain is significantly minimised if not avoided completely.

Combining local anaesthetic and dermal fillers – Local anaesthetic can be mixed with dermal fillers like Radiesse to help reduce the sting of the product being injected. The local anaesthetic literally numbs the area during the treatment.  Other fillers, including filler type JU/JU+/V come with local anaesthetic agents already built in.

Inhaled anaesthetic gas – this can be used in the out-of-hospital setting to achieve a level of anaesthesia/analgesia that is suitable for minor procedures. An example is nitrous oxide, also known as laughing gas, and this is also commonly used for dental procedures or during labour. At The Victorian Cosmetic Institute, we use inhaled anaesthetic gas for anti-wrinkle injections, dermal fillers, laser treatments, prior to local anaesthetic injections, skin needling, and plasma skin regeneration. The anaesthetic gases used tend to wear off very quickly, so that their effect will not linger after the completion of the procedure.

Oral and intravenous analgesics/sedatives  – can be used for the more invasive cosmetic procedures such as liposuction, skin resurfacing, or skin needling. They are usually used in conjunction with other forms of analgesia/anaesthesia such as local anaesthetic injections or creams. Oral sedatives are usually taken one to two hours prior to a procedure to help reduce the anxiety and discomfort associated with procedures. Intravenous sedatives/analgesics are usually given just prior to the procedure, and have a very quick onset.  However, given their effect, it is not possible to drive for 24 hours after having these medications. We also advise  that you fast for 6 hours prior to any intravenous sedation.

Case study 1

A 35 year old with a needle phobia presents to The Victorian Cosmetic Institute for anti-wrinkle injections. She has not had these injections before, and although concerned about her frown lines and crows feet, she is needle phobic and very worried about the procedure. To allay her fears and to help improve the comfort of the procedure, the doctor administers a light form of anaesthetic gas (nitrous oxide) the duration of which lasts about 5 minutes – just enough to perform the procedure. During this time, the patient feels relaxed and distracted from the procedure being performed.

 

Case study 2

A 45 year old male presents to The Victorian Cosmetic Institute for laser skin resurfacing. This is a more in-depth procedure, and usually requires several modes of anaesthesia/analgesia to be used. Firstly, the patient arrives 1 hours prior the procedure to have numbing cream applied to his face. Just prior to the procedure, a light intravenous sedative and analgesic are used which makes him drowsy and go into a semi-conscious state. He is able to talk and respond if necessary, but his memory of the procedure is vague. The face is then injected with local anaesthesia to further numb the face prior to treatment with the laser which he doesn’t feel at all as a result of the above.

Overall, it is very important to us that you have a positive experience at The Victorian Cosmetic Institute. By using all appropriate methods available to help minimise discomfort is of utmost importance to us.

 

Dr. Gavin Chan
Dr. Gavin Chan

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