How to Reduce Pain of Injections: Botox and Filler Pain Control Tips
Pain of injections is—well—painful.
The thing about pain is that it is all in your head—that is, all that activity that hurts is mediated, controlled, and regulated by the brain. Part of the dread of a procedure is the pain of injections that accompanies it.
In our office, we are all about controlling pain.
You may notice that in the office we use vibration when we administered blocks or Botox on all patients that allow us to. If it’s your first-time getting injections, we urge you to try vibration—a handheld device is used close to the location of injection and diminishes the sensation because vibration and pain fibers compete for loci in your brain, and the vibration serves as a distraction that makes it harder to perceive the pain. We cater to patients –all the time–who have described how their previous injections elsewhere were excruciating.
A study that we did in the Aesthetic Journal 10 years ago showed that about 87 % of our patients felt a dramatic decrease in the pain of Botox (neurotoxin) injection. Another study we did confirmed that it worked in patients that were getting filler. (Article references in ASJ)
A new study in the same journal this year from Spain sought to compare topical anesthetic cream versus vibration versus cold anesthesia and confirmed our findings from our study more than 8 years ago: vibration wins out as an anesthetic technique in modulating the pain of facial injections. Cold and cream both came in second over going it without some form of treatment other than cold turkey needles.
Other Useful Techniques for Pain of Injections
- distraction techniques such as tapping, massaging, squeezing, or pulling the skin to the needle rather than pushing the needle through the skin often minimize the discomfort
- ultrafine silicate 32 gauge or 33-gauge needles (27 gauge or 30 gauge are recommended by many injectors—these are smaller.
- multiple needles can be used (they get dull and dull hurts more)
- topical cream and ice both serve as additional supplements
- nerve blocks (twenty minutes of complete numbness) for injections around the mouth
- in worst case scenarios, we have inhalational anesthetics (i.e. nitrous oxide) or can prescribe an anxiolytic (though this is rarely necessary)
In our view, everyone should try pain reduction with vibration.
Alone or in combination, the experience of injections should not be unpleasant—and you should look forward afterwards to a pleasing aesthetic result that does not make you regret the experience.
- A Randomized Controlled Trial of Three Noninvasive Analgesic Techniques for the Prevention of Pain During Facial Injections Enrique Salmerón-González, PhD, MD, Elena García-Vilariño, MD, Alberto Sánchez-García, MD, Alberto Pérez-García, MD, Alberto Ruiz-Cases, MD. Aesthetic Surgery Journal, Volume 41, Issue 1, January 2021, Pages 74–79.
- Investigating the Efficacy of Vibration Anesthesia to Reduce Pain from Cosmetic Botulinum Toxin Injections, Pooja Sharma, Craig N. Czyz, Allan E. Wulc Aesthetic Surgery Journal, Volume 31, Issue 8, November 2011, Pages 966–971.
- Vibration anesthesia for the reduction of pain with facial dermal filler injections Aesthetic Plastic Surgery; Pooja Mally, Craig N Czyz, Norman J Chan, Allan E Wulc 2014 Apr;38(2):413-8.
