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Opening up the milia is usually not felt, but if a comedone extractor is used afterwards there is a mildly to moderately uncomfortable pressure sensation that is very short while the extractor presses on the skin for a few seconds. Not uncomfortable afterwards but there may be a temporary small dent in the skin. The only discomfort is from the injected anesthetic. This varies from almost nothing with buffered lidocaine and a skilled nurse to quite uncomfortable (unbuffered lidocaine and less skill). Your pain tolerance is also a factor.