I had a concussion about 2 months ago.. Today I went into get some botox for my wrinkles on my forehead.. The first injection was on the right side for my face where I had the concussion. I could actually feel the botox being injected ! I could also hear it as it entered.. I have never had that happen. Normally I just feel a little needle prick. I'm a little concerned., is this normal? Thank you so much
March 9, 2015
Answer: This is fine Thanks for your question and I am sure you will have nothing to worryabout – if the injector was a skilled injector. Different injectors inject Botox differently and often we tell our patients that you may hear a crunch sound – and if you do, this is fine. The injections are going into the muscles that we are treating so hearing a crunch sometimes is related to the needle going through the muscle fibers.
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March 9, 2015
Answer: This is fine Thanks for your question and I am sure you will have nothing to worryabout – if the injector was a skilled injector. Different injectors inject Botox differently and often we tell our patients that you may hear a crunch sound – and if you do, this is fine. The injections are going into the muscles that we are treating so hearing a crunch sometimes is related to the needle going through the muscle fibers.
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June 26, 2015
Answer: Damaged needle tips What you describe sounds classic for a damaged needle tip.The needles used for Botox injection are typically 30 or 32 gauge needles. These are the smallest injection needles made.The needles vary in quality based on manufacturer.In my opinion, the needles made by Terumo are of the highest quality.There is published data showing these needles as being superior.A very sharp, small, fine needle tip is exquisitely sensitive to being damaged.Simply pulling the needle out of it's a plastic sleeve and accidentally touching the tip of the needle against the side of the sleeve is enough to damage the tip of the needle.Botox comes in multi-use vials.That means each syringe of Botox needs to be drawn out of the vile using a needle.There is nothing wrong in terms of sterility to use the same needle to inject the medication that was used to draw up the medication from the vial.The problem with this technique is pushing an injection needle through the rubber plunger on a Botox vial will severely damaged the needle tip.Once a tip has been damaged, it causes increasing pain and a crunching-type sound as it enters the skin.The difference is quite pronounced.I can speak as both patient and provider.Typically, if I do a full Botox treatment, it may consist of 20 separate injections.For this type of treatment, I will often use between three and six needles. Any sign the needle tip is not sharp or damaged requires using a fresh needle.I can't say specifically what happened in your case, but what you describe is classic for a damaged needle tip.One other thing we do to keep our patients as pain-free as possible is use powerful topical anesthetics.We use a compounded custom-made numbing agent consisting of benzocaine, tetracaine, lidocaine and phenylephrine.With this topical anesthetic, even five minutes makes a big difference in the perception of pain with an injection.Using the highest quality needles, exquisite technique and topical anesthetic has made our Botox injections virtually pain-free.Trial and error has led me to where I am now, and my technique continues to improve year after year.If you feel comfortable with your provider, then by all means follow up and share your concern.Otherwise, consider finding a new provider.I don't think your previous concussion had anything to do with your perception of the injections.Best of luck,Mats Hagstrom, M.D.
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June 26, 2015
Answer: Damaged needle tips What you describe sounds classic for a damaged needle tip.The needles used for Botox injection are typically 30 or 32 gauge needles. These are the smallest injection needles made.The needles vary in quality based on manufacturer.In my opinion, the needles made by Terumo are of the highest quality.There is published data showing these needles as being superior.A very sharp, small, fine needle tip is exquisitely sensitive to being damaged.Simply pulling the needle out of it's a plastic sleeve and accidentally touching the tip of the needle against the side of the sleeve is enough to damage the tip of the needle.Botox comes in multi-use vials.That means each syringe of Botox needs to be drawn out of the vile using a needle.There is nothing wrong in terms of sterility to use the same needle to inject the medication that was used to draw up the medication from the vial.The problem with this technique is pushing an injection needle through the rubber plunger on a Botox vial will severely damaged the needle tip.Once a tip has been damaged, it causes increasing pain and a crunching-type sound as it enters the skin.The difference is quite pronounced.I can speak as both patient and provider.Typically, if I do a full Botox treatment, it may consist of 20 separate injections.For this type of treatment, I will often use between three and six needles. Any sign the needle tip is not sharp or damaged requires using a fresh needle.I can't say specifically what happened in your case, but what you describe is classic for a damaged needle tip.One other thing we do to keep our patients as pain-free as possible is use powerful topical anesthetics.We use a compounded custom-made numbing agent consisting of benzocaine, tetracaine, lidocaine and phenylephrine.With this topical anesthetic, even five minutes makes a big difference in the perception of pain with an injection.Using the highest quality needles, exquisite technique and topical anesthetic has made our Botox injections virtually pain-free.Trial and error has led me to where I am now, and my technique continues to improve year after year.If you feel comfortable with your provider, then by all means follow up and share your concern.Otherwise, consider finding a new provider.I don't think your previous concussion had anything to do with your perception of the injections.Best of luck,Mats Hagstrom, M.D.
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