6 Tips Pain-Free Injection Botox or Dermal Filler | SkinViva Training
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6 Tips for Pain-Free Injection of Botox or Dermal Filler

By Dr Tim Pearce, MBChB BSc (Hons) MRCGP

The best botox or dermal filler injection is given after a good consultation that has reassured, relaxed and informed the client and enabled the clinician to really understand the aims and expectations of the client while matching that up with their skilled understanding of objective beauty.  

The perfect injection therefore comes as part of a process that starts before the needles are brought out. It’s helped of course by local anesthetic creams, but that’s obvious!  Once the needles are about to be used, there are six other aspects to an injection that help it look and feel as painless as possible.

1. Control the emotional tone

The clients experience will be affected by the emotional tone and body language of you the clinician.

  • Be calm, confident, and lead them with you verbally in the process.
  • Walk and move slowly and predictably.
  • Sign post your movements, for example,  “I’m just going to mark up your face with a pencil, then I will spend five minutes preparing my injections before I come back and the injections will begin”. 
  • Be positive in conversation, and try and keep their mind on more positive things.
  • Talk about holidays and good experiences.
  • Acknowledge anxiety and reassure them kindly.

2. Don’t just focus on the needle…

…be aware of all of your body when injecting

  • Your subject must be in a lying position at 45 degrees with good light, with space around them.
  • Be aware of the weight of your body, focus on feeling planted and secure.  Feet shoulder width apart.
  • Be sure you do not need to lean sideways or twist to reach your patient.
  • Have easy access to the injection point and ask your patient to move slightly to make it as easy as possible.

3. Stabilising the injection point

One of the easiest ways to improve an injection, increase control and decrease pain, bruising and swelling in the process, is to stabilise the point to be injected.

The skin must be stabilised in a way that resists the force of the needle pulling it as you try and penetrate the dermis. A well braced section of skin will be penetrated easily, cleanly and with less pain than an area that is loose and has the ability to move away from the force before suddenly being penetrated and springing back into the needle in an uncontrolled way.

  • Use your left hand (assuming you are right handed), either your thumb or forefinger to hold the skin you are about to inject.
  • Don’t be afraid to pull the skin taught rather than simply put pressure on it.  It’s the tightness that allows for a clean insertion.

4. Stabilise your injecting hand

A hand unstabilised except at the shoulder is pretty uncontrollable for for precise tasks.  The really fine movements you can achieve using your wrist and fingers are lost in the course movement of your upper arm.

The way to regain the control is to stabilise the joint anywhere below the elbow.  It’s common to use the little finger and rest that on another part of the face, but you can use any stable structure for a few seconds.

The mark of an experienced injector is the lack of inhibitions when resting on noses, and other parts of the face the novice is too embarrassed to touch.

5. Controlled needle insertion

This is best done in a deliberate rather than timid fashion, but not fast.  Think not only about the penetration and the end point of the needle, but about the entire course the needle takes while the bevel is on its way to the point you are aiming for.  A good dermal filler injection needs to be in a very precise plane of tissue.

This awareness of the whole journey rather than just the beginning and the end of the needle insertion dramatically increases accuracy, and reduces side effects like pain and bruising caused by crossing into more superficial or deeper planes of skin unintentionally.

6. Inject slowly

Pain is caused unnecessarily by injecting too quickly.  Expanding fluid in a tissue tears fibres apart, and doing it quickly will not allow enough time for the liquid to spread slowly, instead tearing a hole in tissue and causing increased pain and bruising.


Botox and Fillers Training Manchester

SkinViva Training Academy offers a comprehensive range of medical training courses for cosmetic and medical skin treatments.

Their courses are designed for medical professionals such as suitably qualified and registered medical professionals who wish to learn and build on their skills in delivering these procedures.

SkinViva Training was established by by Dr Tim Pearce MBChB BSc (Hons) MRCGP. The SkinViva Training team upholds high standards of clinical training providing a combination of fully-supervised practical experience together with essential theory.

For further information, to discuss which course is right for you, to enquire about availability or to book a training course please call 0161 850 2491, or email info@skinvivatraining.com.

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