Comparing patient satisfaction and pain control between vibration and topical anesthesia during botulinum toxin A injections: a randomized, double-blind, split-face clinical trial

This study aimed to evaluate pain levels, patient satisfaction, and preferences for different anesthetic techniques during the cosmetic application of botulinum toxin A in the upper third of the face. A randomized, double-blind, split-face clinical trial was conducted with 100 women undergoing esthetic procedures for facial wrinkle reduction. Patients were assigned to three groups: vibratory anesthesia versus placebo (Group I), topical anesthesia versus placebo (Group II), and vibratory anesthesia versus topical anesthesia (Group III). Pain levels were assessed using the visual analog scale (VAS). Patients identified the side with better pain control, expressed satisfaction, and provided recommendations for each technique. Group I (vibration 5.02 ± 2.56 vs. placebo 6.00 ± 2.75, p = .034), Group II (topical anesthetic 4.69 ± 2.45 vs. placebo 5.50 ± 2.38, p = .039), and Group III (topical anesthetic 4.89 ± 2.29 vs. vibration 6.06 ± 2.22, p = .048). While satisfaction levels showed no statistically significant differences between techniques, topical anesthesia in Group III received the highest recommendations (p = .010). This study suggests that topical anesthesia and vibratory stimulation both offer small-to-medium analgesic benefits over placebo during BoNT-A injections. Despite comparable satisfaction scores, patients preferred topical anesthesia for future use.