Needle and Syringe Preference in Cosmetic Botulinum Toxin Treatment of the Upper Face

BACKGROUNDThe tools selected for botulinum toxin application can affect patient satisfaction and financial efficiency due to injector dead space, especially with high-priced medications.

OBJECTIVETo compare two injection systems used for upper-face botulinum toxin applications—a 34-gauge needle combined with a low dead space injector (LDSI) and a 30-gauge fixed-needle insulin syringe—with respect to pain, ecchymosis, and product wastage.

METHODSThis prospective, randomized, controlled, single-blind clinical study involved 42 patients. The upper facial region of each patient was divided into symmetric halves. On the study side, botulinum toxin was administered using a 34-gauge needle connected to an LDSI; on the control side, a 30-gauge fixed-needle insulin syringe was used. Pain, bruising, and product wastage were compared between the two sides.

RESULTSThe pain scores were lower across all three regions on the study side than in the control side. Bruising scores were lower on the periorbital and frontal regions on the study side. The control side demonstrated an approximately 2.8-fold higher product wastage than that of the study side.

CONCLUSIONThe use of a 34-gauge needle combined with an LDSI for upper-face botulinum toxin injections may improve patient comfort by reducing pain and bruising, while also decreasing product wastage. These findings should be interpreted as reflecting the performance of the injection system as a whole rather than needle diameter alone.

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