Background: Clinical botulinum toxin (BT) injections are done into recognized anatomical sites with no precise reference lines to make records of our treatments and to plan and position the toxin. Botulinum toxin injections are also characterized for different level of pain on different sites of injection. Objective: The aim of this study is to provide a treatment guide to improve precision and make records, and to evaluate the different levels of pain during the injection. Methods: The same surgeon injected BT into 2 groups of patients; in 25, the authors applied the grid, and in 25 patients the authors did not apply the grid. In the first group of patients, the authors used the new device (Juvapen); for the injection in the second group, the authors performed the injection by the standard procedure. At the end of each procedure, the authors evaluated the level of pain by visual method. Results: Results included 97% degree of symmetry and a 100% patient satisfaction. The mean level of pain in the first group of patient was 3, and in the second group it was 8. Limitations: The authors will apply the grid with the device on a wider population of patients. Conclusions: Facial BT grid analysis lines allow an individualized treatment improving the long-term results. Juvapen permits a less painful injection. (C) 2016 by Mutaz B. Habal, MD.
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