LAUSR

BACKGROUND Microfocused ultrasound with visualization has become one of the more popular nonsurgical facial rejuvenation therapies available. Although the treatment has gained wide acceptance, providing adequate pain relief during the procedure may be challenging. OBJECTIVES We hypothesized that nerve blocks prior to treatment would be well-tolerated and significantly reduce patient discomfort. METHODS Subjects undergoing microfocused ultrasound were offered to participate in a split face nerve block, bilateral block, or a control group. Nerves targeted included infraorbital, supratrochlear, supraorbital, zygomaticofrontal, mental, great auricular, and cervical plexus. Pain was assessed using a 10-point Wong-Backer FACES Pain score. RESULTS A total of 65 patients were included in the study: 28 in the split face group, 19 in the bilateral block group, and 18 without a block. The mean pain score of the bilateral block cohort was 3.9 ± 1.2 (SD), and that of the control group was 5.1 ± 1.7 (p = 0.001). Patients in the split face cohort reported a higher pain score on the unblocked side of the face (7.5 ± 1.3) versus the blocked side (2.9 ± 1.0; p < 0.001). The mean pain score for local anesthetic injection was 2.7 and 1.4 for the split face and the bilateral groups respectively. There were no adverse events. CONCLUSIONS Nerve blocks are well-tolerated and significantly improve patient comfort during microfocused ultrasound treatment without compromising outcomes or increasing adverse events.