How do we manage pain for our patients at Portrait?

A Step-wise approach

Step 1: Pre-Procedure Assessment

• It is important to conduct a thorough assessment of the patient's medical history, including any previous experiences with pain or allergies.
• Evaluate the patient's pain tolerance and anxiety levels to determine the appropriate pain management strategies, based on the planned procedure
• Assess the specific aesthetic procedure being performed and anticipate the potential level of discomfort it may cause.

Step 2: Patient Education and Counseling

• Educate the patient about the procedure, including the potential level of pain or discomfort they may experience.
• Discuss available pain management options and explain the benefits and potential risks associated with each.
• Address any concerns or questions the patient may have to ensure they feel informed and comfortable with the chosen pain management approach.

Step 3: Distraction Techniques

• Employ distraction techniques to divert the patient's attention away from the procedure and help manage pain perception.
  • Provide music, video, or other forms of entertainment to engage the patient's senses.
  • Use of a handheld vibrating device applied to the clavice or near (but not at) the treatment site is an excellent distraction technique.
  • Squeeze balls can help the patient to stay mentally and physically distracted.
  • Encourage deep breathing exercises or guided imagery to promote relaxation and reduce discomfort.

Step 4: Cold Compress or Ice Packs

• Provide a cold compress or ice pack to the patient before the procedure to help reduce pain, swelling, and inflammation. The cold helps to desnsitize the nerves prior to treatment. Biofreeze or similar products can also be helpful, particularly for scalp procedures.
• Instruct the patient on the proper application and duration of cold therapy post treatment, often 10-15 minutes 4-6 times a day as an upper limit.
• Advise the patient to avoid direct skin contact with the cold compress to prevent frostbite, ischemia, or skin damage

Step 5: Topical Anesthetics

• Applying a topical anesthetic cream or gel to the treatment area before the procedure is both very effective and advised
  • Portrait has a numbing cream which can be provided to your patient via Treat days before the procedure.
    • Portrait Numbing 23%lidocaine/7%tetracaine cream or 20%benzocaine/10%lidocaine/10%tetracaine gel should be applied prior to procedure, ideally 30 minutes prior
      • This can be queued for your patient via Treat and will be called in by a staff provider at noon and 5PM PST daily
  • Please ensure that the topical anesthetic has ample time to take effect before initiating the procedure.

Step 6: Local Anesthetics

• Administer local anesthetics, such as lidocaine, to numb the treatment area and reduce pain during the procedure.
  • A 1-2% solution of lidocaine with epinephrine (1/200,000) (approximately 0.2cc per site) can be injected per protocol of planned procedure. Mixing the anesthetic with bacteriostatic saline or sodium bicarbonate at a ratio from 7-9:1 will reduce burning from the injection.
  • Use the appropriate technique for local anesthetic administration, such as infiltration, nerve blocks, or field blocks as per protocol of planned procedure.
  • Monitor the patient closely for any adverse reactions or complications related to the local anesthetic