Left/Right Pain Asymmetry With Injectable Cosmetic Treatments for the Face.
BACKGROUND
Pain is processed and experienced differently on the left (L) and right (R) sides of the body; however, L/R pain asymmetry with cosmetic treatments of the face has not been evaluated.


OBJECTIVE
The authors compared patient ratings of L/R facial pain during and immediately after injectable cosmetic treatments.


METHODS
In this cross-sectional multicenter pragmatic study, pain levels were evaluated for 302 patients who underwent facial treatments with botulinum toxin (BTX) and/or impermanent soft-tissue filler (STF). Patients indicated pain intensity on each side of the face with a visual analogue scale (VAS; 0, no pain; 10, worst pain).


RESULTS
Combined mean VAS scores for BTX and STF treatments (L, 3.79 vs R, 3.42), and individual scores for BTX (L, 3.60 vs R, 3.30) or STF (L, 4.22 vs R, 3.69) treatments were significantly different, with pain rated as worse on the L side of the face (all P < 0.01). When treatments were performed first on the L side, patients rated the overall experience as significantly less painful than when treatments were begun on the R side. BTX treatments with a 29-gauge (G) needle were significantly more painful than with a 33-G needle.


CONCLUSIONS
To lessen pain with injectable facial treatments, the authors recommend placing the first injection on the L side of the face and, when possible, employing a high-G needle.


METHODS
Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands.
Jacobus Johannes
JJ
Fouché
Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands.
Jani Adriaan Jochem
JAJ
Van Loghem
Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands.
Job
J
Thuis
Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands.
Linda Marije
LM
De Heer
Drs Fouché, Van Loghem, and Thuis are aesthetic surgeons in private practice in Amsterdam, Netherlands. Dr De Heer is a Cardiothoracic Surgeon Registrar, Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Netherlands. Dr Van Oijen is an Associate Professor, Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Netherlands.
Martijn G H
MGH
van Oijen
D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001905:Botulinum Toxins / Q000008:administration & dosage / Q000009:adverse effects*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D000067548:Dermal Fillers / Q000008:administration & dosage / Q000009:adverse effects*; D004867:Equipment Design; D005157:Facial Pain / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009339:Needles; D009426:Netherlands; D010147:Pain Measurement; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D065087:Acetylcholine Release Inhibitors; D000067548:Dermal Fillers; D001905:Botulinum Toxins