Skip to main content

Advertisement

SpringerLink
Log in

A Cross-Sectional Survey on Pain Management in Dermal Filler Injections from Physicians’ and Patients’ Perspectives

  • Original Articles
  • Fat Injection
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Hyaluronic acid (HA) dermal fillers injection is a common procedure in patients with cosmetic needs. Concomitant pain is a major complaint among patients undergoing HA filler injections. Relevant research is limited and there is no consensus on pain management of dermal filler injection.

Objectives

To assist physicians in determining a more appropriate treatment approach, and to better provide treatment suggestions.

Methods

A nationwide (China) cross-sectional survey was conducted using questionnaires designed for physicians and patients, respectively. A total of 62 semi-structured questionnaires were administered to aesthetic physicians via face-to-face interview, whereas 123 online-based questionnaires were collected from patients who have ever undergone HA treatment. The collected questionnaire information was analyzed using descriptive statistics and content analysis.

Results

42 (67.74%) physicians observed that over 50% of their patients were concerned about pain during injection. 101 (82.11%) of patients were concerned about impending pain ≥5 points (a total score is 10) before injection. For preferred pain relief modalities, 48 (77.42%) physicians would choose a hyaluronic acid dermal filler with lidocaine, and 82 (66.67%) patients would choose anesthetic-containing products. 59 (95.16%) physicians who injected lidocaine-containing hyaluronic acid found patients had a comfortable treatment experience.

Conclusions

Pain management during hyaluronic acid dermal fillers injection is important from both perspectives of physicians and patients. This survey showed that compared with other analgesic methods, lidocaine-containing hyaluronic acid has offered a more satisfying experience. It also provides insights to physicians and patients in pain management.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Reference

  1. Cui H, Wang G (2023) Minimally invasive approach to facial rejuvenation: the authors’ preferred approach. Clin Plast Surg 50(1):1–9. https://doi.org/10.1016/j.cps.2022.09.002

    Article  PubMed  Google Scholar 

  2. Chimenti RL, Frey-Law LA, Sluka KAA (2018) Mechanism-based approach to physical therapist management of pain. Phys Ther 98(5):302–314. https://doi.org/10.1093/ptj/pzy030

    Article  PubMed  PubMed Central  Google Scholar 

  3. Yoshida T, Otaki Y, Katsuyama N et al (2019) New adalimumab formulation associated with less injection site pain and improved motivation for treatment. Mod Rheumatol 29(6):949–953. https://doi.org/10.1080/14397595.2018.1520426

    Article  PubMed  Google Scholar 

  4. McAllister BJ, Bazo AE (2022) Patient’s perspectives of injection-site pain in intracavernosal therapy. Int J Urol Nurs 16(1):62–64

    Article  Google Scholar 

  5. Babamiri K, Nassab R (2010) The evidence for reducing the pain of administration of local anesthesia and cosmetic injectables. J Cosmet Dermatol 9(3):242–245. https://doi.org/10.1111/j.1473-2165.2010.00503.x

    Article  PubMed  Google Scholar 

  6. Engel GL (1977) The need for a new medical model: a challenge for biomedicine. Science 196(4286):129–136. https://doi.org/10.1126/science.847460

    Article  CAS  PubMed  Google Scholar 

  7. Baumann L, Weiss RA, Grekin S et al (2018) Comparison of hyaluronic acid gel with (HARDL) and without lidocaine (HAJUP) in the treatment of moderate-to-severe nasolabial folds: a randomized, evaluator-blinded study. Dermatol Surg 44(6):833–840. https://doi.org/10.1097/DSS.0000000000001424

    Article  CAS  PubMed  Google Scholar 

  8. Zeiderman MR, Kelishadi SS, Tutela JP, et al (2018) Vapocoolant anesthesia for cosmetic facial rejuvenation injections: a randomized, prospective, split-face trial. Eplasty 18:e6

  9. Wang C, Luan S, Panayi AC et al (2018) Effectiveness and safety of hyaluronic acid gel with lidocaine for the treatment of nasolabial folds: a systematic review and meta-analysis. Aesthet Plast Surg 42(4):1104–1110. https://doi.org/10.1007/s00266-018-1149-3

    Article  Google Scholar 

  10. Weinkle SH, Bank DE, Boyd CM et al (2009) A multi-center, double-blind, randomized controlled study of the safety and effectiveness of Juvederm injectable gel with and without lidocaine. J Cosmet Dermatol 8(3):205–210. https://doi.org/10.1111/j.1473-2165.2009.00451.x

    Article  PubMed  Google Scholar 

  11. Lee JH, Kim SH, Park ES (2017) The efficacy and safety of HA IDF plus (with lidocaine) versus HA IDF (without lidocaine) in nasolabial folds injection: a randomized, multicenter, double-blind, split-face study. Aesthet Plast Surg 41(2):422–428. https://doi.org/10.1007/s00266-016-0769-8

    Article  Google Scholar 

  12. Brandt F, Bank D, Cross SL, Weiss R (2010) A lidocaine-containing formulation of large-gel particle hyaluronic acid alleviates pain. Dermatol Surg 36:1876–1885. https://doi.org/10.1111/j.1524-4725.2010.01777.x

    Article  CAS  PubMed  Google Scholar 

  13. Ballin AC, Brandt FS, Cazzaniga A (2015) Dermal fillers: an update. Am J Clin Dermatol 16(4):271–283. https://doi.org/10.1007/s40257-015-0135-7

    Article  PubMed  Google Scholar 

  14. Royo de la Torre J, Moreno-Moraga J, Isarria MJ et al (2013) The evaluation of hyaluronic acid, with and without lidocaine, in the filling of nasolabial folds as measured by ultrastructural changes and pain management. J Drugs Dermatol 12(3):46–52

    Google Scholar 

  15. Prager W, Micheels PA (2015) Prospective, comparative survey to investigate practitioners’ satisfaction with a cohesive, polydensified-matrix((R)), hyaluronic acid-based filler gel with and without lidocaine for the treatment of facial wrinkles. J Cosmet Dermatol 14(2):124–129. https://doi.org/10.1111/jocd.12136

    Article  PubMed  Google Scholar 

  16. Ehlinger-David A, Gorj M, Braccini F et al (2023) A prospective multicenter clinical trial evaluating the efficacy and safety of a hyaluronic acid-based filler with Tri-Hyal technology in the treatment of lips and the perioral area. J Cosmet Dermatol 22(2):464–472. https://doi.org/10.1111/jocd.15169

    Article  PubMed  Google Scholar 

  17. Xie Y, Wu W, Xu J et al (2022) A randomized, multicenter study on a flexible hyaluronic acid filler in treatment of moderate-to-severe nasolabial folds in a Chinese population. J Cosmet Dermatol 21(10):4288–4293. https://doi.org/10.1111/jocd.14914

    Article  PubMed  Google Scholar 

  18. Diepenbrock RM, May JR, Cone WR Jr et al (2017) Patient preference for preprocedural anesthetic prior to facial cosmetic injectable fillers. Am J Cosmet Surg 34(3):143–149

    Article  Google Scholar 

  19. Smith L, Cockerham K (2011) Hyaluronic acid dermal fillers: can adjunctive lidocaine improve patient satisfaction without decreasing efficacy or duration? Patient Preference Adherence. https://doi.org/10.2147/PPA.S11251

    Article  PubMed  PubMed Central  Google Scholar 

  20. Deloitte Ltd (2022) China medical beauty industry 2022 insight report. Shanghai

Download references

Acknowledgment

We thank all medical students in this study for their contribution to the survey. And Galderma does a good job in questionnaire collection.

Funding

No related funding sources.

Author information

Author notes

  1. Lishuai Shi and Jun Zhang: First author.

Authors and Affiliations

  1. Department of Plastic and Cosmetic Surgery, Tongji Hospital, School of Medicine, Tongji University, No.389 Xincun Road, Putuo District, Shanghai, China

    Lishuai Shi, Jun Zhang, Guobao Wang, Feng Zhou, Lunli Gong, Qiuni Gao & Haiyan Cui

  2. Galderma, Shanghai, China

    Hong Fan & Xiao Xiao

Authors
  1. Lishuai Shi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guobao Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Feng Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lunli Gong
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Qiuni Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hong Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xiao Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Haiyan Cui
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Haiyan Cui.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

For this type of study formal consent is not required.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 15 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shi, L., Zhang, J., Wang, G. et al. A Cross-Sectional Survey on Pain Management in Dermal Filler Injections from Physicians’ and Patients’ Perspectives. Aesth Plast Surg 48, 1417–1425 (2024). https://doi.org/10.1007/s00266-023-03843-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-023-03843-9

Keywords

Search

Navigation