Evidence map›Paper›PMID 38441599›Full record

ArticleAesthetic plastic surgery2024

Subjective Discomfort during Botulinumtoxin Injections Dependent on Injection Site and Needle Size: A Comparison Between 30G, 33G and 34G Needles.

Till A Kämmerer, Randolf Bertlich, Daniela Hartmann, Mark Jakob, Bernhard G Weiss, Ines Bertlich, Friedrich Ihler, Paul Severin Wiggenhauser, Mattis Bertlich

Open access · hybridAbstract readComparative Study
In one paragraph

Article in Aesthetic plastic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 96% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 0 citations in OpenAlex.

  1. Pooled it
  2. Facial Injectable Fillers in Aesthetic Medicine: Clinical Applications and Safety Strategies.Medical science monitor : international medical journal of experimental and clinical research · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Till A KämmererDepartment of Dermatology and Allergy, LMU University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Federal Republic of Germany.
Randolf BertlichDermafit Institute for Cosmetic Dermatology, Hervester Str. 55, 45768, Marl, Federal Republic of Germany.
Daniela HartmannDepartment of Dermatology and Allergy, LMU University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Federal Republic of Germany.
Mark JakobDepartment of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University of Munich, Marchioninistr. 15, 81377, Munich, Federal Republic of Germany.
Bernhard G WeissDepartment of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University of Munich, Marchioninistr. 15, 81377, Munich, Federal Republic of Germany.
Ines BertlichDepartment of Dermatology, Ruprecht-Karls-University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Federal Republic of Germany.
Friedrich IhlerDepartment of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians University of Munich, Marchioninistr. 15, 81377, Munich, Federal Republic of Germany.
Paul Severin WiggenhauserDepartment of Hand and Plastic Surgery, LMU University Hospital, Ziemsenstr. 5, 80336, Munich, Federal Republic of Germany.
Mattis BertlichDepartment of Dermatology and Allergy, LMU University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Federal Republic of Germany. Mattis.Bertlich@med.uni-muenchen.de.ORCID 0000-0002-6479-5899
LMU Klinikum · DELudwig-Maximilians-Universität München · DEHeidelberg University · DEUniversitätsmedizin Greifswald · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBotulinumtoxin application in the face is amongst the most common aesthetic procedures in the head and neck region. It also has numerous medical uses. One of the main reasons for patients to refrain from it is the subjective discomfort that is experienced during injections.

objectivesThe study at hand aimed to determine whether needles with 33G and 34G offer an advantage in terms of individual pain perception during botulinumtoxin injections.

methodsWe conducted a prospective study where patients were asked to grade subjective discomfort on a visual analogue scale for each region (forehead, glabella, temple) that was treated directly after treatment and 15 minutes after. Patients were treated with 30G, 33G or 34G needles, respectively.

resultsNinety-nine patients that underwent treatment of 189 regions were included in the study. Patients were evenly distributed amongst the different needle sizes and regions. Subjective discomfort was greatest in all regions for 30G needles (3.9  ± 1.6 forehead, 4.3 ± 1.7 glabella and 4.0 ± 1.6 temple) followed by 33G (2.7 ± 1.5 forehead, 2.7 ± 1.9 glabella and 2.2 ± 1.2 temple) and 34G (1.7 ± 1.2 forehead, 1.6 ± 1.4 glabella and 1.6 ± 1.4 temple). All differences between needle size were statistically significant (p < 0.05)

conclusion33G and 34G needles seem to offer smaller discomfort during BTX treatments of the head and neck, with 34G being superior to 33G. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Indexed as

Botulinum Toxins, Type ANeedlesPain MeasurementAdultCohort StudiesCosmetic TechniquesEquipment DesignFaceFemaleHumansMaleMiddle AgedNeuromuscular AgentsProspective StudiesTreatment OutcomeYoung AdultBotulinum Toxins, Type ANeuromuscular AgentsBotulinumtoxinDiscomfortNeedle sizePain

Identifiers

PMID38441599
PMCPMC11239724
OpenAlexW4392456185

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.