Among the most common questions expressed during an initial consultation, the issue of pain systematically arises : are the injections painful ? This concern is legitimate, especially since it involves a procedure that breaks the skin in sensitive areas of the face or neck.
However, technical advances, the use of suitable local anesthesia, and the quality of current products now make it possible to perform injections under practically painless conditions, provided they are carried out in a strict medical setting.
It is nevertheless important to distinguish between the different types of possible pain, to understand what causes them, and to explain the means of avoiding or effectively alleviating them.
The potential pain experienced during an injection depends on several combined factors, which must be assessed and controlled by the doctor :
Not all products used for aesthetic injections cause the same level of discomfort or painful sensation during injection. The viscosity, the temperature of the gel, the required volume, or the presence or absence of integrated lidocaine influence the patient’s perception.
Not all areas of the face react the same way to pain. Some are more sensitive than others. Here is an overview of the most frequently injected areas, presented according to their degree of sensitivity :
The choice between a traditional needle and a blunt-tip cannula directly affects the sensation experienced.
The needle :
The cannula :
In practice, the cannula is often better tolerated, especially for deep injections or on extensive anatomical areas.
A common observation in clinical practice is that pain related to injections noticeably decreases over successive sessions. The first injection is often the most feared ; thereafter, patients approach treatments with greater confidence, as they know what to expect. The memory of pain helps reduce perceived discomfort, and local sensitivity can also diminish over successive sessions.
This progression allows the technique to be adjusted to provide maximum comfort, without the need to modify the aesthetic protocol.
In female patients, it is important to note that sensitivity to pain varies throughout the menstrual cycle. During the premenstrual period, some women experience increased hypersensitivity, making the injection experience slightly more uncomfortable.
When possible, it is advisable to schedule injections outside periods of hormonal tension, especially for sensitive areas such as the lips or tear troughs. This helps optimize overall comfort and avoid an exaggerated perception of sensations.
There is no formal contraindication to aesthetic injections solely related to fear of pain. However, in certain specific cases, increased attention to patient comfort is necessary :
In these patients, pain management involves a relationship of trust, a detailed explanation of the procedure, carefully adapted anesthesia, and a calm and reassuring environment. Under these conditions, the injection is well tolerated in almost all cases.
After an injection, it is possible to feel slight discomfort, local tension, or sensitivity to touch, particularly in highly mobile areas such as the lips or nasolabial fold. These sensations are temporary and usually disappear within 24 to 48 hours, sometimes a little longer.
In some cases, mild swelling or a small bruise can make the treated area temporarily sensitive. This is not true pain, but rather discomfort that can be relieved by applying local cold, using arnica (in cream or granules), and avoiding muscular efforts such as chewing or intense exercise during the first 24 to 48 hours.
The perception of pain is, by definition, subjective : it depends on individual sensitivity, emotional context, stress level, and memory of previous pain. A very anxious patient will perceive sensations more intensely, even if they are minimal.
That is why the quality of the doctor-patient relationship, clear explanation of the treatment steps, and psychological preparation play a fundamental role in injection tolerance. A reassuring approach, a calm environment, and a slow, gentle injection can sometimes transform a feared experience into a comfortable, even painless, procedure.
In very rare cases, for extremely phobic or hypersensitive patients, a mild anxiolytic (such as hydroxyzine or low-dose alprazolam) may be prescribed before the session. This approach remains exceptional, as most patients, once well informed, tolerate the procedure perfectly.
However, it is important never to minimize expressed anxiety and to offer concrete solutions for patient comfort : prolonged application of anesthetic cream, pauses during the injection, semi-reclined position, relaxing music.
There are several techniques to minimize the pain experienced by the patient, without compromising the precision of the procedure or the aesthetic outcome.
Article written by Dr Romano Valeria
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