Botox EXTREMELY Painful Injection? Doctor Answers, Tips
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Botox EXTREMELY Painful Injection?

I've had botox a few times. No problems. Minimal pain... if any. I just got back from my appt. The injections were excruciating. To the point that I cried. And I have a high tolerance. The dr eventually injected himself in the forearm. He found it extremely painful. Yet he told me there's nothing to worry about. Have you heard of this? Do I need to be worried? The dr gave me his cell. He sounded confident it would be fine. But at the same time, it had never happened to him before.

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21 Doctor Answers | Asked by adogg in Delray Beach, FL
+3

Painful Injections with Botox

This is very uncommon as Botox is typically injected with a extremely small gauge needle and rarely results in any significant discomfort. As others have stated, it may be possible that the Botox was reconstituted with an incorrect solution.
+3

Painful Botox

This is very unusual to have painful injections. This pain can be caused by what the particles are mixed with in the office. Sterile water and non peservative saline can be uncomfortable. These will not cause a problem with your health or treatment. However, if the Botox was accidentally mixed with hypertonic saline this can cause an ulceration. It will sting a lot going into the skin. This could happen if the office also does sclerotherapy for spider veins and uses this for... more
+3

Solution

A agree with the others. The pain of Botox injections should be minimal, especially if pre-treated with a topical anesthetic. Most likely the Botox was reconstituted with bacteriostatic water rather than saline. Preserved saline has benzyl alcohol, besides being a preservative, has a mild numbing effect. The difference between preserved saline and bacteriostatic water can be substantial. While the package insert states that we should be using non-predserved saline, very few offices use this.... more

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+3

Botox injections should not be painful

Botox injections might be a little uncomfortable but should not be PAINFUL. I agree with the others and think that the problem was with what the Botox was reconstituted with. Bacteriostatic saline makes the injection the most comfortable. The worst scenario would be if someone used hypertonic saline by mistake. If this was the case you would already know as this could cause ulceration. It is most likely that they used sterile water and that does hurt more. more
+3

It sounds odd and the thought of injecting himself sounds even odder!

While I am sure this is a great way to check it out, the thought of injecting himself seems over the top! Botox pain can be due to the way it is reconstituted (how the powder that Botox comes as is made into a liquid). It is possible that his office staff changed their fluid and there is a possibility that the wrong fluid was used this time. Generally, this won't cause major issues, but it is somewhat concerning if major pain is noted. I have also noted that women who... more
+2

Painful Botox injection

Botox injections should not be painful, and should cause only minimal discomfort. I don't think the pain you experienced was due to poor technique; rather, it was probably related to the solution that was used to reconstitute the Botox.
+2

Botox

Botox is very NOT painful. If it is painful, it can be due to a small nerve that is there
+2

Pain post botox

Yes this is unusual but can happen.the pain should subside and putting ice on the area will help eleiminate the pain but you should do well.
+2

Painful Botox

Hi. I agree that you should only have minimal discomfort with Botox injections. If the pain is persistent I would recommend seeking evaluation and staying in close communication with your physician.
+2

Botox Injections Painful

It is very unusual for Botox injections to cause great discomfort. Just keep in contact with your physician should you notice any issues.
+2

Botox injections and pain - not common

It is not likely the Botox itself but the solution that was used to reconstitue this product. I agree with the other doctors about saline versus sterile water. Make sure you get normal saline reconstituted Botox next time you get these injections.
+2

May have been reconstituted with sterile water rather than saline solution

Most likely cause of this, if you are already familiar with your own pain tolerance for Botox injections, is that the Botox may have been reconstituted with sterile water rather than saline. This is a sometimes a cause of abnormally painful injections. The office may have sterile water there for Sculptra.
+2

Pain after botox injections

I agree with the other doctors that the problem is almost definitely with the saline used to reconstitute the Botox and not the Botox itself. Botox is manufactured under stringent, controlled conditions. As long as the product was purchased directly from the manufacturer (Allergan) and not through a third-party distributor, there is very little to be concerned about. As with any injections, definitely call your doctor if you notice anything unusual. I suspect you wrote this question... more
+2

Botox injections should not hurt

Botox comes as a sterile freeze-dreid powder that must be reconstituted with saline solution to prepare it for injection, and there are different types of saline that can be used. Your experience sounds very unusual and more likely related to the solution used rather than injection technique.
+2

Painful Botox

I agree with what others have said. There may have been some different substance, ie sterile water, used to hydrate the Botox. Preservative free saline does not usually cause extreme pain like you describe, so it may have been water. Since you have had Botox before with no significant pain, it certainly sounds like there was something different about the injection that day. I wonder if other patients that day had the same experience?
+2

Painful injections

Another reason for the injections to be soo painful it that instead of saline solution for the Botox dilution, sterile water was used. Sterile water is very painful when is injected, check with your doctor.
+2

Unusually painful Botox injection

I think it is a reconstitution issue. Botox is normally reconstituted with normal saline. If it is mistakenly reconstituted with sterile water, the injection is very painful. Sterile water is in the office if the doctor also uses Sculptra.
+2

Botox injections should be minimally painful

If your Botox injections were extremely painful, then I would ask if the saline was preservative free or not. With the preservative, although off label, it is less painful and typically the way I use Botox. I would also question if you really did get Botox. If the doctor did not get it directly from the company (which would be illegal) then you risk having an unknown substance injected.
+2

Botox and painful injections

It's not common for you to have pain at all, maybe some minor discomfort during Botox injections. I would discuss with your provider what the product was reconstituted with (preserved or non-preserved saline), and make sure you follow up with any further issues.
+2

Botox injection extremely painful

This happened to me a few months ago, and I was actually injecting my daughter who has been treated a number of times before. Turns out the med supply company had shipped us a batch of sodium chloride that didn't have preservatives in it. I would never have told you the preservatives would have made a difference, but apparently they did in this case with the Botox dilution. I still don't know why. I reported the incident to Allergan just to be safe, and my daughter's treatment was 100%... more
+1

Painful Botox Injections

The Botox injections that you had could have been reconstituted with bacteriostatic water instead of bacterostatic normal saline. There is no harm, it just stings when injected.
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Comments (1)

adogg 14 Mar 2013
Thank you everyone for your answers. Thankfully everything turned out fine. My doctor is extremely reputable so there was no question of the source of Botox. He called his rep and personally followed up with me the next day. It seems as though it was an issue with reconstituting as you all suggested. The pain subsided very quickly. And now I'm seeing the same usual results - maybe not quite as much as I regularly do but most likely because he wasn't able to inject as much with all of my crying. No side effects. All is well. And thanks again!

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