Investigating the Efficacy of Vibration Anesthesia to Reduce Pain From Cosmetic Botulinum Toxin Injections

Background: Many analgesic modalities have been employed with limited success to alleviate the pain associated with botulinum toxin type A (BTX-A) injections. Vibration is an effective method of reducing pain during facial cosmetic injections, but it has not been previously studied in the context of clinical cosmetic procedures. Objectives: The authors evaluate the safety and efficacy of vibration-assisted anesthesia for reducing pain associated with BTX-A injections. Methods: In this prospective study, 50 patients received BTX-A injections for cosmetic rhytid reduction. Injections were given in a split-face design that was randomly assigned. A vibration stimulus was coadministered with BTX-A injections on one side, while the other side of each patient's face received BTX-A injections alone. Patients completed a questionnaire immediately posttreatment and were contacted for follow-up three to four weeks later. Results: Patients reported less injection pain on the vibration-treated half of the face as compared to the control side (an average of 1.3 vs 2.4 on a five-point scale; P = .000). Overall, 86% of patients preferred to receive vibration with their next BTX-A treatment. There was no significant difference between first-time and repeat BTX-A patients in terms of preference for vibration. Five of 50 patients experienced transient side effects perceived to be associated with vibration, including tingling teeth, increased bruising, and headaches. Of the patients who did not request vibration with subsequent BTX-A injections, none cited decreased BTX-A efficacy as the reason for their preference. Conclusions: Vibration is a safe and effective means of reducing patient discomfort during BTX-A injections for cosmetic rhytid reduction and may have applications in other cosmetic procedures.