Botox EXTREMELY Painful Injection?

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.

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?

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.