by Dr. David Deng
In today’s modern society, aesthetic treatments have become a commonplace. The latest aesthetic procedures and products are hot topics often discussed amongst both medical practitioners and patients.
However, what is less spoken about but equally important is pain management for aesthetic procedures. The aesthetic outcome is important but what is equally crucial is being able to alleviate as much discomfort as possible for our patients during various procedures performed to achieve the desired results.
Today’s medical practitioners should strive to achieve an experience for our patients to minimise the fear of pain and dealing effectively with any physical pain during aesthetic procedures. Although we may not be able to provide a pain free experience during aesthetic procedures, we must certainly strive for a less painful experience when administering our treatments.
Creating a relaxing atmosphere in the aesthetic clinic is important. The aim is to create a welcoming and relaxing ambience where patients look forward to come for their treatments. Making sure that the consultation and treatment procedure is not rushed is also important to keep patients relaxed. Additional props such as music and scented candles will help to set the tone for a relaxing experience.
I believe that the initial consultation offers a crucial opportunity to understand our patients concerns and expectations, including how much pain they anticipate for various aesthetic procedures. Explaining the procedure and the deliberate steps that will be taken to relief pain will reduce patients’ anxiety. When patients are calm and relaxed any physical pain during the actual procedure itself will also be reduced.
Methods of Pain Relief
There are various methods of pain relief that we can use in combination to reduce any discomfort that patients may feel during aesthetic procedures.
Dr. David Deng performing an aesthetic procedure
Talk therapy. By speaking in a calm and confident manner, an experienced injector will provide patients with less anxiety. Patients who are less anxious will therefore experience less pain during the procedure.
Vibrators. These handheld devices provide good pain relief when applied under the chin during injectable treatments such as botulinum toxin and fillers, by blocking nociceptors from picking up painful stimuli.
Numbing cream and ice pack are routinely applied to the areas of treatment prior to lasers and injectable treatments. These help to decrease the pain from laser beams hitting the skin and needle puncturing the skin during injectable treatments. Numbing cream is routinely applied at least for 30 to 45 minutes prior to start of the aesthetic procedure. Further, ice pack also helps to reduce the risk of bruising.
Oral painkillers can also be given to patients who are more sensitive to pain and anxious before injectable treatments. Examples include paracetamol, non-steroidal anti-inflammatories and opiods. These are given one hour prior to the actual procedure. Always check if patients have any drug allergies prior to prescribing analgesics.
Good injection techniques can help to significantly reduce pain during botulinum toxin and fillers administration. For botulinum toxin treatment, fine 30 Gauge insulin needles are used in a controlled and swift manner. This minimizes the discomfort during the process of needle puncturing the skin. The botulinum toxin is then administered slowly to minimize the discomfort from administrating the actual toxin into the muscles.
For fillers, I prefer to use the cannula instead of direct needle technique as it helps to significantly reduce discomfort and increase safety with regards to vasculature. After the initial puncture of the skin using an appropriate sized needle, a blunt tip cannula is then used to introduce the filler and injected in a gentle and controlled manner. Slow injection of fillers reduces the pressure and swelling sensations when the fillers injected fill up the volume in soft tissue spaces. Generally, the smaller the volume of filler product injected, the lesser the displacement of soft tissue and the lesser the pain level perceived.
Needle vs. Cannula Technique | Pic Source: InjectMate
Further, using a cannula rather than a needle to introduce fillers means only 1 to 2 needle punctures are made on each side of the face rather than several repeated needle punctures using the direct needle technique.
Last but not least, fillers that contain lidocaine pre-mixed or added to them will help to reduce the discomfort during injection.
In summary, managing patients’ pain in today’s aesthetic practice requires understanding patients’ concerns and managing their expectations as much as using various methods of pain relief outlined above to limit actual pain. With so many pain relief methods and treatment techniques available today, we as medical practitioners must constantly re-evaluate and update our protocols to strive for a better patient experience.