Why does Botox make me faint, but fillers don't?

Hi Brooke, this question does come up occasionally. Without an evaluation, it's difficult to tell why it would occur with the Botox but not the injectable fillers; however, it is highly unlikely that this was caused by the Botox itself.I don't know your specific aesthetic goals, but the good news is that Botox is likely not your only option for treatment. I would either follow up with your physician or schedule a formal evaluation with an experienced cosmetic dermatologist to explore your options. Best, Dr. Emer 

It's difficult to say why your would have a vasovagal response to one but not the other. You may want to take a few precautions before treatment. Make sure that you are well hydrated and not too warm. You can use cool compresses on your inner elbows and around your neck. In our office we often employ tapping during injections to help our patients during treatment. I've included a video on this that I hope you find helpful.

Dear brooke,Feeling faint after injections is common.  Many patients can experience a vaso-vagal response from any injection.  It's a normal, short-lived physiology stress response but can be quite scary when it happens.  For patients prone to vaso-vagal reactions, I will inject in the reclined position;  Pre-icing the area and making sure the patients are well hydrated before treatment can also help.  Make sure you inform your surgeon so that precautions can be made to try and minimize any discomfort during the procedure.  Best of luck!

Hi Brooke,
Thanks for your question.  Patients respond differently to the sight and thought of needles and medical treatments including botox and fillers.  It would be unusual that the botox medication itself is causing you a true vaso-vagal reflex.  A medical evaluation from your medical doctor is something that you should still consider.  Another tip would be for you to ask your injector if he or she has any tools that can be used to "distract" you during the procedure.  These include (but are not limited to) vibrating devices, ice compresses, squeeze-balls, all which may make the procedure more tolerable for certain patients.  Best of luck in the future!
Dr. Kieliszak

Thank you for your question. There could a variety of reasons, however you would need a medical evaluation to determine the possibilities.  In some people the sight of blood or needles can cause a vaso-vagal response, but this is not related directly to Botox. 

There’s no reason attributable to the Botox that would cause this to happen. It’s possible that some subtle anxiety regarding Botox is triggering this. Perhaps it’s simply the anxiety of it possibly happening again. Worrying about fainting is a sure path to more vasovagal events.   Vasovagal responses are interesting. I have patients who are perfectly fine until I use certain medical words or describe something in too much detail. In other words, it often has more to do with your thoughts than with pain.   Rest assured the Botox itself is not the problem. Ask your injector to inject you while somewhat supine. This may help.    Best to you. 

I am not sure why the Botox makes you faint. I use very very small needles which most people barely feel even going into the skin.  Perhaps ask your injector to use a smaller needle on you when getting Botox. I wish you the best, Dr. Ardeshirpour

No reason at all as far as the molecule itself is concerned. Maybe you perceived it as more painful as juvederm has lidocaine (anaesthetic) built into it?