Recently, more and more aesthetic clinics—not just plastic surgery clinics but also dermatology clinics—have begun offering sleep sedation.
Many people are interested in treatments like fillers, thread lifts, Rejuran, Ulthera, and Thermage, but hesitate because of the pain.
(I totally understand—I'm also very sensitive to pain…)
Our clinic also provides sleep sedation, so today I’d like to objectively share whether sleep sedation for Rejuran, Thermage, and Ulthera is truly safe.
What types of sleep sedation are used?
Propofol (commonly known as the “milk injection”)
Propofol is the most well-known sleep sedative and is commonly used in aesthetic dermatology. Our clinic also uses propofol.
Because it is a white, opaque liquid, it is often referred to as the “milk injection.”
One of propofol’s main features is that it provides a refreshed, well-rested feeling after the procedure, and its short duration of action makes it easy to manage.
However, the downside is that it does not completely block pain perception. While patients usually don’t remember the discomfort afterward, they may still feel pain during the procedure. Additionally, overdosing can paralyze the respiratory muscles and cause respiratory failure, so it must be administered with caution.
Midazolam
Midazolam is a sedative commonly used in internal medicine and family medicine, especially for procedures like endoscopy.
One of the key reasons midazolam is widely used is that it has an antidote (reversal agent), which allows for emergency intervention if needed.
Compared to propofol, midazolam induces a lighter state of sleep, which allows for light communication with the patient during the procedure and makes it easier to detect discomfort or unusual symptoms.
However, it also carries a risk of respiratory suppression, and because the body takes longer to metabolize the drug, patients may feel dizziness or drowsiness for about an hour after the procedure.
Ketamine
Ketamine is a sedative commonly used in minor surgical procedures, especially in plastic surgery.
Its biggest advantage is that it rarely causes respiratory suppression and is effective in blocking pain perception.
For this reason, it is sometimes used in procedures involving incisions. However, it increases airway secretions, which may lead to airway obstruction, so careful monitoring is required. Additionally, patients may experience headaches, nightmares, or psychological discomfort upon waking, so the use of ketamine should be approached with caution.
Summary of Sedation Types
Sedative
Advantages
Disadvantages
Propofol
Refreshing upon waking, fast metabolism and clearance
Risk of respiratory suppression
Midazolam
Allows conversation, has an antidote
Risk of respiratory suppression, slow recovery
Ketamine
Less pain, minimal respiratory suppression
Psychological discomfort, risk of airway blockage
Is Sleep Sedation Safe for Rejuran, Thermage, and Ulthera?
The advantage of sleep sedation is that it helps reduce pain, and in the case of propofol, it provides a sensation similar to having had a pleasant, restful sleep
However, in my opinion, using sleep sedation for procedures like Rejuran, Ulthera, or Thermage is not always recommended.
Here are the reasons why:
1. Sleep sedation is not completely risk-free.
If any side effects or complications occur, there must be a qualified medical professional with proper knowledge of anesthesia present at all times. Without a fully prepared emergency response system, these situations could develop into serious medical issues
2. There are cases where the actual procedure is misrepresented.
Even at well-known clinics, there have been cases where the doctor performing the procedure is switched while the patient is under sedation, or the energy settings are deliberately lowered to shorten the treatment time—all without the patient’s knowledge.
While more clinics now show patients the number of treatment shots used, it’s still important to confirm that a trusted physician is personally performing the procedure.
In Korea, CCTV installation in treatment rooms is now mandatory by law, so it’s also important to check that the system is functioning properly.
Worried About Pain? Are There Other Options?
During consultations, I usually recommend the following two options:
Apply lidocaine numbing cream thoroughly for at least 30 minutes
Combine it with facial nerve block injections (local anesthesia)
When performed properly, these two steps can significantly reduce pain for most patients.
For those who are still very anxious, I may suggest sleep sedation—but only within safe limits.
At our clinic, sleep sedation is administered directly by medical staff with international certifications such as ACLS,
and our sedation program is designed under the supervision of an anesthesiology specialist.
Still, I always approach sedation procedures with a strong sense of responsibility and caution.
Unless you have an extreme fear of pain that makes it truly unavoidable, I do not recommend sleep sedation for aesthetic treatments like Rejuran, Thermage, or Ulthera—for the sake of both safety and optimal results.
In Summary – 3 Key Points
The most common sedatives used are Propofol, Midazolam, and Ketamine, with Propofol being the most frequently used in dermatology clinics.
Sleep sedation is not entirely risk-free, and it must be carefully managed by experienced medical professionals.
Pain can be greatly reduced using numbing cream and facial nerve blocks, so it's best to try these options first.
That concludes this information about sleep sedation for Ulthera and Thermage treatments.
I hope this article has been helpful for those considering the procedure.
If you have any questions or concerns about the treatment, feel free to leave a comment.
I’ll be happy to respond with care and detail.
Thank you.
📍 Primi Clinic
3F, 52 Seongsuil-ro, Seongdong-gu, Seoul (Primi Clinic)
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