Three-point Method Nerve Block for Relieving Pain of Microbotox Injection in Middle and Upper Face

Background: With the popularity of microbotox, pain caused by multiple microdroplets and subcutaneous injection of botulinum toxin is increasing. This study presents a new, refined, three-point nerve block technique that provides effective pain relief during minimally invasive injection therapy targeting the middle and upper face. Methods: Fifty volunteers underwent facial ultrasonography to measure the locations of the supraorbital and infraorbital foramen. Following microdrop Botox injection of the middle and upper face, 100 patients underwent a self-controlled study to analyze whether a three-point nerve block surpasses topical anesthesia for reducing injection pain. The visual analog scale pain score, the time of the three-point method and botulinum toxin injection, and side effects were recorded. Results: Among the volunteers, the location of the supraorbital and infraorbital foramen showed no statistical difference between the left and right sides. For the 100 patients (13 men, 87 women) who underwent the three-point nerve block, the visual analog scale pain scores on the experimental side were significantly lower than those on the control side, except in the frontotemporal region (2.46 ± 0.50, 2.42 ± 0.47, P > 0.05). The duration of the unilateral three-point nerve block was 74.8 ± 5.64 seconds. The total injection time was 189.86 ± 26.79 seconds (range 148–286 s). Conclusions: The three-point method exerted prominent analgesic effects during middle and upper facial treatments, with benefits including a precise block region, high satisfaction, and simple operation technique. Therefore, clinicians can easily master and apply this method.