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• W1978133645 abstract "Sir: I read with interest the article entitled “Minimizing Pain, Maximizing Comfort: A New Technique for Facial Filler Injections” published recently in the Journal. Drs. Rohrich and Herbig allude to the increasing numbers of patients who have either dermal fillers or neurotoxin injections for restoration of a more youthful facial appearance. They likewise espouse the necessity for a preinjection anesthetic for a more comfortable patient experience. They recommend the off-label addition of 2% lidocaine to a number of fillers. The other viable alternatives to help alleviate the pain of cosmetic injectables include anesthetic creams, vibration devices, ice, cool air, nerve blocks, local infiltration of lidocaine, and contact cooling devices. The anesthetic creams require some 30 to 45 minutes to take effect, and their numbing effect may last long after the injectable procedure. Ice, because it freezes at the freezing point of water, can cause a frostbite-like feeling that can be painful to the patient. The addition of local lidocaine into the area of anticipated injectable placement can distort the area, making the judgment of how much filler to place difficult. The injection of the lidocaine can cause a bruise and can take some time to set up. Vibration devices, cool air–blowing machines, and contact cooling devices can be costly and may require the aid of an assistant for easy application. I describe a novel, patent-pending adjunct to dermal filler or neurotoxin injections that addresses all of these shortcomings stated above. The Ouchless Needle (Fig. 1) is a syringe-attached vapocoolant dispenser that is activated with one hand just before dermal filler or neurotoxin injections. It sprays a mixture of 1,1,1,3,3-pentafluoropropane and 1,1,1,2-tetrafluoroethane, both of which are nonflammable, chlorofluorocarbon-free vapocoolants. The Ouchless Needle vapocoolant spray mixture numbs instantly, obviating the 45-minute waiting period for topical creams, and has a few-second duration of effect. Because neurotoxin and filler injections are sequential and in multiple noncontiguous locations, the addition of lidocaine to the dermal filler may not produce enough of a numbing effect to help with the subsequent injection. I still add lidocaine to the fillers, as I believe this adds to the decrease in postinjection pain and throbbing.Fig. 1.: The Ouchless Needle on a Juvéderm (Allergan, Inc., Irvine, Calif.) syringe.The efficacy in pain reduction of vapocoolants as compared with topical creams for decreasing pain of intravenous cannulation1,2 in children and immunization pain3 has been described in the literature. Weiss and Lavin4 have recently published a split-face study of botulinum toxin type A patients in which half the face was sprayed with a vapocoolant and no treatment was applied to the other half. Overall, 67 percent of patients reported that the vapocoolant side had less pain and 54 percent preferred vapocoolant for their next treatment. The addition of a syringe-attached vapocoolant dispenser such as the Ouchless Needle can make for a more comfortable injection experience for our patients, which may allow us to reach out to those patients who would otherwise not consider an injectable cosmetic enhancement secondary to fear to the needle pain. It will also alleviate the patient's time commitment, allowing for a shorter appointment time. Marc J. Salzman, M.D. Institute of Cosmetic Surgery 6420 Dutchman's Parkway Louisville, Ky. 40205 DISCLOSURE The author is the chief executive officer and founder of the BellaNovus Development Company (Louisville, Ky.), which makes and distributes the Ouchless Needle device." @default.
• W1978133645 created "2016-06-24" @default.
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• W1978133645 date "2010-05-01" @default.
• W1978133645 modified "2023-09-25" @default.
• W1978133645 title "A Novel Pain-Alleviating Adjunct to Dermal Fillers and Neurotoxins" @default.
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• W1978133645 doi "https://doi.org/10.1097/prs.0b013e3181d5136f" @default.
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