PRF + Deep Microneedling for the Upper Eye — Why Facial Nerve Blocks Change What's Possible

The principle: depth determines outcome

For the periocular area specifically, depth is constrained by what the patient can tolerate. The upper eye, crow's feet, and brow region are densely innervated — aggressive depth without anesthesia is unacceptably painful. So most clinics default to superficial settings, which limits results.

Facial nerve blocks: the differentiator

A facial nerve block is a regional anesthesia technique used routinely in surgery and pain medicine. Small amounts of local anesthetic are injected at specific peripheral nerve sites — the supraorbital and supratrochlear nerves (forehead, upper eye), the infraorbital nerve (cheek, upper lip), the zygomaticotemporal nerve (temple, lateral brow) — producing complete numbness across the entire territory those nerves supply.

Performed correctly, the result is:

• Complete numbness across the upper-eye and forehead area for 60–90 minutes
• No surface anesthetic cream needed — deeper than topical can reach
• Comfortable for the patient throughout — even at maximum microneedling depths
• Recovery is normal — sensation returns over a few hours; no lingering effects

Performing these blocks safely requires training in regional anesthesia and a precise understanding of facial anatomy. Aesthetic clinics without medical anesthesia training are generally limited to topical creams, which numb only ~1 mm into the skin — nowhere near deep enough for aggressive microneedling.

Dr. Amos Ben Harav is a board-certified anesthesiologist. Facial nerve blocks are within his core specialty, performed routinely and safely. This is one of the things that distinguishes La Clinica from aesthetic-only clinics.

Why this matters specifically for the upper eye

The upper-eye area is one of the most demanding zones for microneedling for several reasons:

• Thin skin — doesn't tolerate uncontrolled aggressive treatment, but conversely benefits from real dermal stimulation
• Periorbital nerves dense — pain tolerance without anesthesia is poor
• Movement — blinking and squinting during treatment makes precise needle work difficult; relaxed muscles (during nerve block) help
• High patient expectations — this is the area patients scrutinize most; weak results are noticed

With proper facial nerve blocks, the entire upper-eye area can be treated at needle depths matched to the tissue:

These depths are routinely used in our clinic. They're not routinely available at most aesthetic clinics in the upper-eye area because patient tolerance without proper anesthesia is too limited.

Why combine with PRF specifically

Microneedling alone creates micro-injuries that trigger a wound-healing response. PRF amplifies this response by depositing concentrated growth factors directly into the channels created by the needles. The synergy:

• Microneedling channels expose deep tissue to PRF that wouldn't normally reach it
• PRF growth factors signal sustained collagen formation over ~10 days
• The PRF fibrin matrix holds the signal in place rather than washing away
• Cumulative result: meaningfully stronger collagen response than microneedling alone

For the periocular area specifically, the PRF is prepared as i-PRF (liquid form) using Dr. Miron's horizontal centrifugation protocol — the modern standard. It's applied both topically (across the microneedled surface) and as small injections at strategic deep points.

What deep PRF microneedling treats well in the upper-eye area

• Crow's feet (static and dynamic) — often combined with botox; PRF microneedling addresses the skin component, botox the muscle
• Fine lines on the upper eyelid skin
• Mild dermatochalasis — tightening from collagen build (less than CO2/Morpheus 8 but with the additional skin-quality benefit)
• Periocular skin quality / texture / tone
• Forehead horizontal lines (skin component, not muscle — botox handles muscle)
• Skin laxity in the brow area

What it doesn't do: significant dermatochalasis (need laser or surgery); fat herniation (surgical); true ptosis (surgical); brow descent from muscle imbalance (botox).

What a session looks like

1. Consultation — identify treatment zones; confirm candidacy; discuss what facial blocks will be used
2. Blood draw — 20–40 ml for i-PRF preparation
3. Facial nerve blocks — performed by Dr. Ben Harav. Tiny amounts of lidocaine at the supraorbital/supratrochlear nerves (forehead/upper eye), and others as needed. Numbness develops within 5–10 minutes.
4. i-PRF preparation — concurrent with the numbness onset
5. Microneedling — depth set per zone (1.5–3 mm typically); covers the planned area systematically; takes 15–20 minutes
6. PRF application — topical across treated surface; targeted injections at strategic deep points
7. Recovery — cooling, occlusive ointment, sunglasses, discharge

Total in-clinic time: ~90 minutes. Most of which is the nerve block onset and PRF preparation; the treatment itself is shorter.

Recovery

• Day 0–1: redness, mild swelling. Tiny pinpoint marks where needles entered. Sensation returns over a few hours. Apply ointment.
• Day 2–3: most redness gone. Makeup OK. Most patients are presentable for work.
• Day 4–5: normal appearance.
• Week 2–6: skin quality and tightening improvements emerge gradually.
• Months 2–3: full effect of single session visible.

Typical series: 3–4 sessions, 4–6 weeks apart. Maintenance every 6–12 months.

vs Morpheus 8 vs CO2 laser

Further reading

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