There are many ways to control tension and pain during injections, including ice packs, local anesthesia, regional blocks, peripheral nerve blocks, and hyaluronic acid products using a mixture of local anesthetics (lidocaine). Local anesthesia can be used between the eyebrows, nasolabial folds and corners of the mouth, such as topical betacaine, lidocaine and dicaine 20 to 30 minutes prior to injection. However, clinicians should be aware of the potential for allergic reactions and contact dermatitis from these drugs. Topical anesthetic ointments can be used. Ice packs may also be applied, not only to prevent pain but also to avoid swelling. There are many different injection methods available to the physician, and although it is recommended that the needle be beveled upward, in practice it can be oriented in any direction. It has been found that hyaluronic acid always goes in the direction of least resistance, independent of the direction of the needle. The choice of needle depth needs to rely on experience to achieve the desired result. Less pressure can be noticeably felt when injecting in the subcutaneous fat layer than when injecting in the dermis. Injecting too superficially can cause blanching, depressions or skin protrusions. Classically, the needle is inserted at 30° to 60° and then injected while retracting the needle. The angle of needle advancement varies from person to person. The most commonly used injections include continuous linear injections and multi-point injections, while in more extensive areas, such as the lateral cheekbones, fan injections and reticular cross injections are generally used. Continuous linear injections involve slow and smooth injection of filler over the entire or major injection area as the needle is withdrawn. Multi-point injections are similar to this, but multiple entry points are taken on the line for injection. Fan injections are also to be injected by entering and then retreating the needle, although more different angles are used depending on the size of the area. Finally, the web cross is injected along many intersecting parallel and perpendicular lines. Regardless of which method is used, be sure to stop the injection when the needle leaves the skin so as not to cause surface nodules.