There is minimal to no discomfort. Dr. Rubinstein minimizes discomfort by using the smallest available needles for the injections. Botox is packaged freeze dried and needs to be dissolved in saline (sterile salt water). Dr. Rubinstein uses a special type of saline that takes the sting out of the injection. Applying ice to the area just before the injection further minimizes any discomfort. Although numbing cream is not necessary, applying numbing cream 30 minutes prior to the injection (ordered through Dr. Rubinstein’s office) makes the injection pain free.