Does It Hurt? Pain Levels by Treatment and What Happens in a Session

This is the question asked in the final minute before booking, usually quietly.

And most answers you find are useless — either “not at all” (inaccurate) or “it depends on your tolerance” (not an answer).

So let’s answer it properly: every treatment and how it feels, which areas differ, and exactly what happens from the moment you walk in.

The short answer

With topical numbing cream, most injectable treatments feel like a light prickle or pressure, not pain in any usual sense. Botulinum toxin is the mildest — a very brief prickle, because the needle is fine and the volume minute. Lip filler is the most sensitive, because the lip is densely supplied with nerve endings; if that’s your plan, the numbing must be given its full time. The session itself runs 10 to 45 minutes depending on treatment, plus 15 to 30 minutes of numbing.

Sensation level by treatment

This table reflects what patients actually describe, on a scale of ten:

Treatment	Sensation	Most common description
Botulinum toxin	1 – 2	A quick prickle, like an ant bite
Skin boosters	2 – 3	Repeated light pricks
PDRN	3 – 4	Prickling plus a brief stinging
Cheek / chin filler	3 – 4	Pressure more than pricking
Sculptra	3 – 4	Pressure and fullness
Radiesse	3 – 4	Noticeable pressure
Under-eye filler	4 – 5	More sensitive, more bruising
Lip filler	5 – 6	The most sensitive

Why are lips highest? The lip has a denser supply of nerve endings than anywhere else on the face. That’s anatomy, not exaggeration.

Why is toxin lowest? The needle is extremely fine, the volume injected at each point is tiny, and the depth is relatively superficial.

Numbing: the step that matters more than anything else

Most pain complaints I hear from patients who came from elsewhere share one cause: the numbing wasn’t given its time.

Topical anaesthetic needs 15 to 30 minutes depending on the area and skin thickness. Applied and then injected five minutes later, it has barely worked.

There are other layers of comfort depending on the treatment:

Anaesthetic within the product. Most modern fillers contain lidocaine in the formulation, so the first entry is the hardest and everything after is considerably easier.

Cooling the area. Cold compresses before injection reduce both sensation and bruising.

Cannula instead of needle. In certain areas such as the under-eye, a cannula — a flexible tube with a blunt tip — reduces the number of entry points and markedly reduces bruising.

Dr. Rehab Zakaria’s advice: “If someone tells you the session takes ten minutes including numbing, ask how much of that is numbing. Giving the anaesthetic its full time transforms the whole experience. I prefer patients to sit a little after the cream rather than going straight in — the difference is noticeable.”

What happens in a session, step by step

This is the order in our clinic, and broadly the standard in any serious practice:

1. Assessment and examination (10 – 20 minutes)

Questions about medical history, medications, supplements, allergies and previous procedures. Then an actual examination — skin thickness, elasticity, muscle movement, volume distribution.

If this step is skipped, that’s a warning sign, not time saved.

2. Agreeing the plan

Product, quantity, areas, full cost, and expected side effects. This is the right moment for your questions: product name and manufacturer, how many millilitres, and whether the packaging will be opened in front of you.

3. Pre-treatment photographs

Consistent lighting and angle. Important so you can compare honestly later — gradual change is hard to notice without them.

4. Cleansing and antisepsis

A simple step, but fundamental to infection prevention.

5. Numbing cream (15 – 30 minutes)

You wait. Use the time for any question you’ve remembered.

6. Injection

Treatment	Injection time
Botulinum toxin	10 – 15 minutes
Filler	20 – 30 minutes
Skin boosters	20 – 40 minutes
Sculptra	30 – 45 minutes

7. Settling and instructions

Cold compresses if needed, and aftercare instructions. Ask for them in writing — they’re delivered quickly and forgotten on the way out.

What you’ll feel immediately afterwards

In the first hours: tightness or fullness at the injection sites, mild redness, and sometimes small bumps at each entry point. All expected.

The next day: you may find a bruise, particularly under the eyes or in the lips. Those bruises aren’t an error — they’re the nature of those areas.

Persistent pain? Not expected. Mild tenderness to touch on day one is fine, but genuine ongoing pain warrants a call.

Signs requiring immediate contact

Not every sensation is normal. These require contacting your doctor straight away:

Severe or increasing pain rather than easing · skin turning pale or blue · redness increasing after day three · warmth in the area · any change in vision — an immediate emergency.

Full detail in our guide to injectable side effects.

How to reduce both sensation and bruising

Things genuinely in your control:

Avoid blood thinners beforehand — aspirin, ibuprofen and supplements such as omega-3 and vitamin E increase bruising. (Never stop a prescribed medication without consulting your doctor.)

No alcohol for 24 hours before.

Book at an unhurried time — a session taken while stressed or short of sleep is harder.

Eat beforehand. Light-headedness after injection is usually down to arriving on an empty stomach.

Say something if it hurts. There’s no prize for enduring it. Something can always be done — more anaesthetic, a pause, a change of technique.

Frequently asked questions

Does it hurt more than a blood test?
Most patients say no, because of the fine needle and the numbing. Lip filler is the exception.

Do I have to watch the needle?
If it worries you, close your eyes or look away. There’s no need to watch.

Will I feel the product inside?
In the first days you may feel fullness or slight irregularity; it settles with time and with massage where your doctor has prescribed it.

Can I go back to work afterwards?
For most treatments, yes. The exception is visible bruising or noticeable swelling.

It’s my first time — what helps?
Start with something straightforward like toxin or a skin booster session, ask for the full numbing time, and say at the outset that it’s your first time.

The bottom line

Do aesthetic injectables hurt? Honestly: there is a sensation, but far less than most people imagine — provided the numbing is given its time.

Botulinum toxin is barely felt. Filler and boosters are comfortably tolerable. Lips are the hardest, and if that’s your plan, prepare for it mentally and insist the numbing gets its full duration.

And most importantly: the sensation lasts minutes, the result lasts months. But the decision should rest on information, not on surprise.

📄 The full picture: Everything you need to know about aesthetic injectables · The safety guide · 30 questions about injectables

At Dr. Rehab Zakaria’s clinic in El Tagamoa, New Cairo, numbing time is not shortened, and aftercare is demonstrated rather than handed over on a sheet.

To book or ask a question: WhatsApp 01064022402.

Disclaimer: This article is for general medical education and is not a substitute for medical consultation. Never stop a prescribed medication without consulting your doctor. Any aesthetic procedure should be preceded by an individual assessment from a qualified doctor.