Objectives: This presentation aims to demonstrate that a structured, landmark-based facial nerve block protocol offers a practical and highly effective solution for pain control in aesthetic procedures. By standardizing anatomical landmarks and safety steps, this approach enhances injection precision, reduces patient movement and complication risk, and improves procedural efficiency, while remaining accessible and applicable without ultrasound guidance. Introduction: Facial nerve blocks are essential for pain control and motor inhibition in minimally invasive aesthetic treatments (e.g., skin booster, laser therapy, filler injections). While ultrasound-guided methods offer precision, landmark-based techniques remain indispensable in resource-limited settings or for rapid interventions. This study evaluates a structured landmark and protocol to optimized the accuracy, safety, and reproducibility without advanced technology base on clinical practice in Indonesia. Materials / method: A prospective study of 150 Indonesian patients (2024–2025) undergoing facial aesthetic procedures was performed. Landmark-based facial nerve blocks (supraorbital/supratrochlear, infraorbital, and extraoral mental) were administered using mid-pupillary alignment. Safety measures included 30G needles, aspiration, compression, and motor testing. Outcomes were block success, complications, procedural time, and VAS satisfaction. Results: Success Rate: 98.6% achieved complete sensory block. - Safety: one intravascular injections/orbital injury; one case of transient paresthesia (resolved ≤48 hours). - Efficiency: Mean time ≤90 seconds/site. - Patient Satisfaction: 9.6/10; 98.6% reported "pain-free" procedures. Conclusion: This protocol demonstrates that systematic landmark techniques ensure precision and safety in facial nerve blocks without ultrasound. Critical innovations include: - Pupil-centric foramen mapping for consistent accuracy. - Extraoral mental block approach reducing mucosal trauma. - Aspiration-integrated workflow mitigating vascular risk. - Compression soon after injection to make it spread well. Landmark methods remain a vital, accessible tool for aesthetic practitioners—prioritizing practicality without compromising efficacy

Disclosures - Theressia HANDAYANI

> Did you receive any funding to support your research for this TOPIC?
No

> Were you provided with any honoraria, payment, or other compensation for your work on this study?
No

> Do you have any financial relationship with any entity which may closely compete with the medications, materials, or instruments covered by your study?
No

> Do you own or have you applied for any patents in conjunction with the instruments, medications, or materials discussed in your study?
No

This work was not supported by any direct or indirect funding. It is under the author's own responsibility

Injectables

Published on July 30th, 2026 - Recorded during IMCAS Asia 2026

Keywords:

Anatomy Anatomy for injections Brow (non-surgical) Combined treatments Drug delivery Lower face & submental (non-surgical)

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Dr. Saad AL BARADONI

2 weeks ago

Excellent and practical presentation. A clear understanding of anatomical landmarks is essential for performing facial nerve blocks safely and precisely. Thank you for sharing this valuable technique.

Practical precision in landmark-based facial nerve blocks

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