Most patients find injectable treatments with fillers or neurotoxins to be quite easy to tolerate. We routinely apply ice prior to injecting for its numbing effect. Some patients prefer to have their skin numbed with topical ointment that can be applied about 15-20 minutes prior to the injections, and provides additional comfort by making the small needle pricks barely perceptible, if at all. If you are interested in having numbing ointment applied prior to your treatment, please make our front desk staff aware of this fact either when scheduling your appointment or upon arrival at the office, so that the staff can be aware of your needs and avoid unnecessary waiting on your part.
We do, however, have some patients for whom numbing ointment and/or ice do not provide an adequate solution. These include people for whom the thought of experiencing needle pricks provokes too much anxiety. For such patients we offer 3 options.
The first and simplest is oral sedation, given as a pill to be taken on an empty stomach about 30-40 minutes prior to the injection.
The second option involves IV (intravenous) sedation, also known as ‘twilight’ anesthesia. This option, which must be scheduled in advance, involves our anesthesiologist providing gentle relaxation using short-acting medications, which are administered intravenously. With this technique, the patient’s level of relaxation is precisely controlled. Because the medications used are very short acting and adjustable, the patient generally has no memory of any discomfort during the procedure, and has a feeling of relaxation and well-being, even euphoria, after the treatment is complete. If you decide upon IV sedation, know that you are in good company, as this is the technique used by Dr. Rapaport when he undergoes injections.
A third option, available for some procedures, is a medical nitrous oxide gas very similar to the laughing gas you might have at the dentist. Pro-Nox is a patient-controlled system that provides non-opioid, safe, and effective pain and anxiety relief to patients during small procedures.
"I generally have an excellent pain threshold,” affirms Dr Rapaport. "But maybe because I inject people all day long, when it comes time for me to be injected, I simply feel anxious. With IV sedation, I can rest assured that from the minute Dr. Grillo starts my IV, I will be feel relaxed and will be safe, cooperating, and breathing on my own, but will have no memory of the event and will feel very well afterwards.”
Your level of consciousness will be based on your wishes and needs, and will be influenced by the type of procedure you are undergoing. Dr. Rapaport will arrange to discuss these factors in depth with you during your confidential consultation.
Please be aware that should you choose oral or IV sedation, you will not be permitted to drive for the rest of the day.