Does Botox Hurt?

Do BOTOX shots hurt?

That’s a better rephrasing of the question of “Does Botox Hurt?”

This is a question I get in my Modesto Botox Practice – Surgical Artistry – almost every single day.  It’s a difficult one to answer because everyone is different.  But I’m going to attempt to answer it in this blog.

The quick answers from me:

It is sometimes tempting to answer with: “Let’s try it and see.”

Or, sometimes I’m tempted to say “It doesn’t hurt me one bit when I’m injecting it.

EMR frustrations Calvin Lee
Not to worry, I don’t use a hammer when injecting BOTOX.

OK, some serious thoughts on the topic of BOTOX pain:

In general, most people think that BOTOX shots hurt a little bit but is bearable.  I would venture and say that perhaps people even look forward to coming back for BOTOX shots.  Perhaps they forget how painful the shots could be.  I get BOTOX injections myself, and I would say that they hurt a little bit but not enough for me to complain about it.  But I also think that there are variables to what causes pain with BOTOX injections:

What are some causes of pain with BOTOX shots?

I’ve divided these into Injector and Patient factors

– Injector factors

  • Injection technique  – “hands of a woman, heart of a lion, eyes of an eagle” – a strange mantra passed on to me by a surgery mentor while I was a Surgeon-in-training.   There is so much to this topic – it wouldn’t all fit here.
  • Size of the needle.  Smaller is usually better.
  • Did we hit bone? ouch!  But sometimes this is part of the technique to gauge depth.  Not usually necessary though – in my humble opinion.
  • Is the needle dull? – a dull needle causes more pain.  I have found that needles – even from the same batch might be sharper or duller when brand new out of the box.
  • Did the needle become dull?  It could become dull after a few shots (same patient of course!).  The Botox injector could change the needle after a few shots to start “fresh.”  Or the needle could become dull if it was purposefully or inadvertently “banged” against certain anatomic structures such as bone, or it could have been used to extract the Botox from the sterile bottle (not my practice – though).
  • How often are we going to change the needle?  Changing it often is a good thing, especially with the smaller needles.  Smaller needles dull pretty quickly.
  • Did we hit a nerve?  This would hurt.
  • Did we hit a blood vessel?  This would hurt too.

– Patient factors

These are just my thoughts from my experience of injecting Botox patients:

  • Nervous patients usually feel more pain.
  • Tensed muscles usually get more pain.
  • Patients who squirm around during injections usually suffer more pain.
  • Patients who haven’t experienced raising children (or birthing them) usually experience more pain.

Summary about pain with BOTOX shots

Pain is a very individual experience.  But I’m glad to report that lots of patients like their BOTOX visits and come back regularly for more BOTOX visits.  I think that tells me that it isn’t a really terrible pain.  And I consider myself to be the biggest CHICKEN in the world (just ask my wife the Plastic Surgeon), and I think that BOTOX shots are just fine for myself.

My wife, Dr. Tammy Wu, by the way, won the Best Cosmetic Surgeon award this year.


I’m vegan, I need to find a different word for “CHICKEN.” – perhaps a future blog.  Please see your own injector regarding Botox Pain Perception questions.  Reading this blog does not automatically make me your doctor.  Read at your own risk.  Do not try this at home.  The FDA has nothing to do with this web page.

Please visit my Modesto Botox Home Page for more important information.

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