Botox Pain

[BobLoblaw78]

I have had many patients that have previouslly received multiple rounds of botox injections who all of the sudden find the injections to be very painful. It is the same product and same procedure without any changes. It has been going on for a couple of months. Has anyone noticed this as well? Is it seen with transport or storage of botox. I tried to research it but haven't come up with any answers. The botox still seems to be working. Changing diluents hasn't helped. Any ideas or observations?

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[deleted875186]

I have had many patients that have previouslly received multiple rounds of botox injections who all of the sudden find the injections to be very painful. It is the same product and same procedure without any changes. It has been going on for a couple of months. Has anyone noticed this as well? Is it seen with transport or storage of botox. I tried to research it but haven't come up with any answers. The botox still seems to be working. Changing diluents hasn't helped. Any ideas or observations?

Haven’t noticed. Can’t imagine it’s from the Botox since you have to reconstitute. Any changes no needles? I used to use a small 27G 1/2 inch BD needle but found they often had a small barb or something at the end, seems like it happened often, made the injection uncomfortable for patients.

 

[epidural man]

Headache protocol or something else?

Try changing product to Xeomin - see if that makes a difference.

 

[BobLoblaw78]

Haven’t noticed. Can’t imagine it’s from the Botox since you have to reconstitute. Any changes no needles? I used to use a small 27G 1/2 inch BD needle but found they often had a small barb or something at the end, seems like it happened often, made the injection uncomfortable for patients.

I use 30G1/2 inch BD needle. I considered moving to 32G but it doesn't seem to matter.

Headache protocol or something else?

Try changing product to Xeomin - see if that makes a difference.

Headache protocol. Good idea to consider switching to xeomin. But it will still haunt me as to why this is happening.

 

[epidural man]

I use 30G1/2 inch BD needle. I considered moving to 32G but it doesn't seem to matter.

Headache protocol. Good idea to consider switching to xeomin. But it will still haunt me as to why this is happening.

When doing headache protocol, I switch the needle after two or three spots. Patients were complaining of increased pain.

Someone years ago posted an electron microscope picture of a needle tip after each use. It was the coolest thing. I wish I could find that again. The needle (on a microscopic scale) gets so jacked up after each poke.

 

[DODOCSS]

n=30/month

Drawn into 5 different syringes (5 needles), 30g

Zero issues

 

[deleted875186]

When doing headache protocol, I switch the needle after two or three spots. Patients were complaining of increased pain.

Someone years ago posted an electron microscope picture of a needle tip after each use. It was the coolest thing. I wish I could find that again. The needle (on a microscopic scale) gets so jacked up after each poke.

I think this is a big thing, especially if your hitting periosteum around the skull.

 

[drrosenrosen]

Yeah I try to be careful not to hit bone; that really jacks up the needle tip. I put mine into four tb syringes each with a 30ga 1/2in needle. Have never had any complaints about undue pain.

 

[Ducttape]

this is not the article you are thinking of, but this is what came up first. ill try to find that other article...

Deformation of Needle Tips During Facial Soft Tissue Filler Injections: An Electron-Microscopic Study

AbstractBackground. Injectable soft tissue fillers are used on a global scale for a variety of aesthetic indications. Despite their widespread use, there i

academic.oup.com

 

[MitchLevi]

Yeah I try to be careful not to hit bone; that really jacks up the needle tip. I put mine into four tb syringes each with a 30ga 1/2in needle. Have never had any complaints about undue pain.

Same.

Makes the math easier too.