Background: Injection of neuromodulators, such as botulinum toxins, is a common procedure. Used on-label, neuromodulators are safe and effective, but injection is often accompanied by pain.

Objectives: The aim of the study is to understand whether administration of botulinum toxin injections with a vibration device improves patient comfort.

Methods: This single-center, randomized, split-face, controlled study evaluated 1 treatment session with botulinum toxin A (5 injection points) for correction of moderate-to-severe glabellar lines administered ± a vibrating beauty bar to improve comfort. After treating the corrugator muscle on 1 side, vibration was added or discontinued for the other side according to randomization; patients selected the method for procerus muscle injection. Patients were aged 18 to 64 and treatment naive. Pain was assessed on a visual analog scale (0 = none, 10 = worst imaginable), and questionnaires assessed treatment experience and preference.

Results: Sixty patients completed the study. Mean pain assessment score for the group was 4.9 (standard deviation [SD] = 2.1) for injections administered without vibration compared with 4.0 (SD = 2.2) for those with vibration. Those with the first 2 injections with vibration reported a mean pain of 3.8, which increased to 4.8 for injections without vibration. Results were numerically higher for patients who had the first 2 injections without vibration, with mean scores of 4.9 without vibration and 4.2 with vibration. Investigator pain assessments were similar. Most (81.7%) patients chose vibration for the fifth injection. Patients had a positive perception of added vibration.

Conclusions: Both patients and investigators reported reduced pain/improved comfort when a vibration device was paired with the aesthetic treatment injection.

Steven Dayan MD

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