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When using a high-gauge needle like a 30G or 31G, most people report feeling very little, often just a tiny pinch or nothing at all
Botox is a prescription drug
Shoulder pain has many causes, including referred pain from the cervical spine, thoracic outlet syndrome, and cardiac conditions (especially left shoulder pain)
In other words, the schedule is a sensible default that a clinician can adjust, not a fixed rule you should try to bend on your own
But, serious side effects are rare
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