Extremely Painful Botox Injections

Botox injections should not be painful.  Depending on the area and technique, the feelings should range from imperceptible to mild discomfort.  It should never be very painful.  If you experienced severe pain with multiple injections, my first suspicion is that the injector mixed sterile water with the Botox instead of saline with the Botox.  This does indeed cause significant pain with injection.  Other than that, unless they used a large gauge needle (I use 31 gauge), there really isn't any reason for it to be that painful in multiple areas.  There are several other techniques to minimize the discomfort including numbing the area with a spray or ice, gating techniques, superficial injections, etc.  I would strongly recommend seeing a different injector for hopefully a different experience.

Hello 19103.  Generally speaking our patients do not have trouble with pain from Botox injections.  As has been suggested by another practitioner, it may have something to do with the gauge (size) of the needle, normally very small needles are used for Botox.  We also periodically have a patient that uses a cold pack for a few seconds at the injection sites and this helps numb the area temporarily before the injection.

A steady and gentle hand can also help minimize any discomfort.  Hope this helps and good luck.

slow injections, small needles and not too deep an injection should make botox injections not very painful.  If the bone were touched by the needle deeply, or the injection very quick or the needle larger than necessary then the injections might be more painful. botox should be diluted prior to use and if the diluent used was not the water that should be but some other solution, then maybe it hurt more for that reason.

There are several reasons for this. Occasionally the Botox can be refrigerated and cause pain due to the temperature difference. Other reasons include the dliuent; the preservative in the saline and buffered preparation may actually make it less painful. Numerous smaller volume injections versus larger bolus injections may also diminish the pain. In any event, it is possible to irritate a nerve which can cause pain that radiates to the forehead or scalp.

Painful Botox injection most likely due to a dull needle. Often when drawing up the injection, the needle can be dulled, which adds to the discomfort of the injection.

Everything  that you mention is possible. Every time you have a stick even with a tiny needle bleeding occurs under the skin and muscle. This bleeding afterwards causes pain and swelling.  Furthermore it is possible to have heavyness and tightness  all over your head after botox injections. It is also possible that you may have bruised by now as well.  It is also possible that it was your first time and you were too sensitive to it.

Anyhow things wil get better in a few days.

Thank you for your question 19103. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam where the entire medical history is reviewed. However, I hope the information provided here is useful.One of the most common questions regarding Botox is whether the treatment is painful. We use a painless technique to maximize our patients comfort during the treatment. This starts by reconstituting the product with preserved saline, which contains benzyl alcohol, to decrease the discomfort with the injection. We use a tiny needle, similar to the size of the needle used for TB test on the forearm. During the treatment, we provide a relaxing environment by playing a calming video with gentle music. We provide stress balls to our patients to hold during their treatment. We apply cold air on the area which serves to numb the skin. We also use the Beauty Bar, which is a vibration device which distracts the patient from the injection itself. Finally, with experience, I have developed a technique to inject to minimize pain. This includes pinching the area, pushing the skin into the needle (as opposed to pushing the needle into the skin), using a slight rotation, and using gentle pressure. Most patients are surprised at how comfortable the treatment is.If I had a patient with the concern described here I would say that everyone is different in terms of sensitivity to discomfort and she may want to look for a doctor who uses techniques described above to provide comfort during the treatment.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

Several factors may have caused your pain.  Since it was your first time, you may have been anxious.  Women are more sensitive to pain during their menstrual cycle.  Methods your doctor can use to relieve discomfort include:

using preserved saline for reconstitution of Botox

using a very small, sharp needle

slow, more superficial rather than deep injections

pre-treating the areas with ice

applying an anesthetic cream a few minutes before the treatment

Hopefully your next treatment session will be more comfortable.

If you consider having another Botox treatment, you may ask your doctor to rub an ice cube on the injection site for a few seconds to briefly numb it up.

Overall Botox injections are not very painful.  A very small needle is used and most patient tolerate the procedure extremely well.  There is a very small percentage of patients that do not  tolerate any pain well.  For these patients pretreatment with a topical anesthetic might be necessary.  It is very uncommon, but a few people require it even for the most minor procedures.