Botox injection in pain, is that normal? Was not relaxed!

They have you smile so they can get a better idea of exactly where the bands are. There us no issue with injecting while you are smiling or while you have a neutral expression.
Hope his helps!Dr. Halka

It is okay to inject the platysmal bands while they are flexed. Sometimes, this may result in more temporary discomfort. However, the discomfort should resolve within 10-14 days. If it persists after this time frame, please follow up with your provider.

Yes, that can be normal. Some injectors give Botox into the platysmal bands while they’re flexed, others when relaxed — both are valid. It often hurts more if injected into a contracted muscle, but you’ll likely be fine. Expect some soreness or bruising. Rarely, too much spread can cause neck weakness or mild swallowing issues; if those happen, contact your provider. Otherwise, it should pass in a few days.

Thank you for your question and I'm sorry to hear that your experienced was more painful that usual. Every injector has their way or technique they are comfortable with or trained with. In my practice, when injecting platysmas bands I always ask the patient to smile or flex the neck, then I ask then to remain in that position as I pinch the band and inject while the band is flexed, not relaxed. Just like your injector did. Everything seems to be done correctly. I hope your pain resolved and you have a wonderful neck result. The worst things that could have happened was to affect your smile for a few months or that you were unable to lift your neck from flat position without assistance.
Have a beautiful day. Best, Dr.Anna Avaliani, NYC

Thank you for sharing your experience. Injections can be more or less uncomfortable from time to time, but should not be very painful. You might want to ask your doctor to apply a bit of topical anesthetic cream prior to the treatment. I hope this helps!
Good luck,

Thank you for your question. It is normal for an injector to ask you to flex your muscles. This allows them to see where the bands are and where to place the Botox injections. It is also not uncommon to experience pain after the injection (it might be an effect of bruising), but any side effect should be mild and temporary.

I recommend scheduling an in-person consultation with a skilled and experienced injector who can evaluate your concern, skillfully inject Botox, and safely provide the best possible results.

Our practice, we nearly always inject all facial muscles while somebody is moving the muscle, not while relaxing. Some treatments can leave a little more pain than others but in our experience, it all goes away. I hope this is helpful! Sincerely, Dr Joseph

You are ok. The injector wanted to know exactly where the bands were and could see them well when they were flexed. It is possible that the additional pain is just a coincidence (e.g. a little bruise under the skin). There's not much that could have gone wrong here and you should expect a nice result.

Hi MP,
As long as you injecting physician places the Botox properly in your muscle it does not matter whether your are smiling or relaxed. The pain that you are experiencing should be very short lived and is most likely due to a small bit of bleeding from the needle in the muscle. You will be okay and you do not need to worry about significant adverse effects, again as long as the proper amount of Botox was used. Please feel free to contact me with any further questions or concerns. Good luck and be well!

Michael Persky, MD
Encino, CA

Based on our 25 years experience with Botox, there should be no difference injecting relaxed vs. flexed muscle; injection may be more painful when injecting tense muscle band than relaxed? Hope this helps.