Which of the treatments is the most painful?

Question

I am very needlphobic and was wondering how painful some of these treatments are and how deep the needles go for botox/juviderm type treatments.

Scott Trimas, MD · Answer

Typically if you are concerned about the needles, I would recommend that you consider asking your physician to prescribe for you a mild sedative prior to the injection of either botox or filler. That being said, both are typically done with small needles and my patients tell me it is more the area to be treated than one product hurting more than the other. I will give my needle phobic patients a topical anesthetic to use and put on the area for about 45 minutes before the injection and that virtually eliminates all of their discomfort. Good luck in your area.

Jason Emer, MD · Answer

My patients have very minimal pain from botox and fillers.  We use cannulas for fillers to limit pain, swelling and bruising.  For botox we use very small needles.  Best, Dr. Emer.

Nelson Castillo, MD · Answer

Thank you for your question.  Minimally invasive procedures, such as Botox or Juvederm, are typically well-tolerated by patients with minimal pain or discomfort.  The pain of the injections depends on the area of the body treated, with typically areas around the lips and mouth more painful than the cheeks, laugh lines, or forehead.  Discomfort can be limited by several measures, including ice compresses, topical numbing medication or nerve blocks.  Be sure to see an ASPS board certified plastic surgeon for consultation.

Steven L. Ringler, MD, FACS · Answer

If you're concerned about being uncomfortable prior to facial injections, please be sure to let your physician know before treatment.  Most of these treatments are performed with very small gauge needles and the area being treated can be cooled with gel packs prior to treatment. There are also topical numbing agents that can be used to help keep you comfortable. Keep in mind, you always have the option of trying one small injection to see how you feel before proceeding.  Most of our first time patients are very surprised how comfortable they stay during treatment. Having a very experienced physician who is sensitive to your concerns would be a good place to start.  Best of luck to you.

John Mesa, MD · Answer

Cosmetic procedures that require the use of injections like Botox and Fillers may cause some minor discomfort at the time of injection. Since very small needles are used, most patients tolerate the injection procedures very well.Certain patients with anxiety and phobia to needles may require special protocol to undergo needle based cosmetic procedures.In my practice, patients that would like to be treated with injectables are pre-treated with topical numbing medication and icing for at least 20 min before the procedure. In severe case of phobia, my patients may be given an small dose of anxiolytic if their are accompanied by a responsible adult that could drive the patient back home. Therefore, the painfulness of a cosmetic treatment based on injections depends on the practitioner's skill that provides the injection

Alex Eshaghian, MD, PhD · Answer

Thank you for your question Charli Voll. Botox is a purified protein used to address wrinkles associated with facial expression. Needles used for Botox are very small, similar to those used for a TB test on the forearm. Needles used for fillers are slightly larger, but still very small. Most people tolerate these treatments well. In our office we apply numbing cream before filler treatments to maximize our patients' comfort. Most fillers also contain numbing ingredients to further improve comfort. We also use a painless Botox technique. Cold air is applied to the injection site to numb the area. We also reconstitute Botox with preserved saline, which contains benzyl alcohol, which makes the injection more comfortable. With any injectable treatment there is a risk for pain. For my patients with a low pain threshold or who cannot tolerate pain I recommend avoiding such treatments. Please consult with a doctor for specific
recommendations. Good luck!

Steven Wallach, MD · Answer

Botox and filler injections are often performed with very small gauged needles often after using a topical anesthetic.  The injections are usually fairly superficial or just within the subcutaneous tissue below the skin.

Keith Denkler, MD · Answer

Botox to the crows feet is extremely superficial as the muscle is just under the thin skin.Frown muscles are deeper.Juvederm is placed into the skin or just under it.Topical anesthetics, ice, and small needles help.A topical botulinum toxin is being developed by Revance Therapeutics for use in hyperhidrosis.It is in stage II clinical trials, so will take several years to come out.

Which of the treatments is the most painful?

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