title: Putting it all together: recommendations for pain management in nonsurgical facial rejuvenation.
abstract: BACKGROUND
  Nonsurgical procedures for facial rejuvenation vastly outnumber surgical procedures among board-certified plastic surgeons; interest in nonsurgical cosmetic procedures is rapidly growing for patients and physicians, with less down time, less scars, and potentially less cost. Nonsurgical procedures are often a gateway for patients into more invasive surgical procedures. Providing patients with a comfortable, pleasant experience increases the chance of referrals and return for future procedures, surgical and nonsurgical.
  
  
  METHODS
  In this review article, we describe basic principles for providing patients with a pleasant, minimal pain experience during nonsurgical facial rejuvenation procedures. The procedures are grouped into injectables, noninvasive devices, and minimally invasive devices, and basic guidelines for pain management are provided.
  
  
  RESULTS
  A review of each nonsurgical facial rejuvenation procedure is provided with typical patient perception of discomfort and methods to reduce or eliminate pain. This article covers the most popular procedures performed in many plastic surgery offices but is not inclusive of all devices and technologies available on the market.
  
  
  CONCLUSIONS
  A wide range of nonsurgical options exist for rejuvenation, and there is nearly as much variety in pain associated with these procedures. As with any procedure that potentially may lead to pain or anxiety for a patient, it is important to assess patient's pain tolerance preprocedurally to determine the level of intervention needed. Providing a relaxed, calm environment and satisfactory pain control helps to reduce anxiety and improve the overall perception of the procedure and provider.
authors.affiliation: Boca Raton and Weston, Fla. From the Sanctuary Plastic Surgery; Department of Plastic Surgery Cleveland Clinic Florida; and Department of Surgery, Florida Atlantic University.
authors.forename: Megan C
authors.initials: MC
authors.lastname: Jack
authors.forename: Jason N
authors.initials: JN
authors.lastname: Pozner