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Can Botox be used in areas other than the frown lines?

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Botox is a neuromodulating protein that reduces the stimulation of muscles by the nerves. When injected in key places, the movement of facial muscles is reduced and that results in a decrease in lines. The FDA has approved the use of Botox for frown lines. This means the FDA has reviewed the effectiveness and safety when Botox is injected into the corrugators and procerus muscles, commonly called the frown complex. When a drug has been approved for use for one indication, practicing physicians often try the drug for other uses that conceptually should work by the same principal. They then present their experience at continuing educational meetings.

For many years now, dermatologists and plastic surgeons have been using Botox for indications other than the “elevens” (THE FROWN LINES BETWEEN THE BROWS). The crow’s feet and forehead lines are the most common wrinkles injected “off-label” by experienced physicians. The treatment of all three of these areas at the same visit can also result in a reshaping and lifting of the brows.

The use of Botox in the lower face is another “off-label” way to improve lines and reshape the face. Botox is injected into the fine lines around the mouth to reduce “lipstick” lines. It can be injected into key areas to reduce the downward pull of certain muscles and result in a lift of the corners of the mouth. When injected into a muscle near the nose, a gummy smile (where too much gums show at full smile) can be improved. A muscle on each side of the nose can be injected to eliminate the “bunny lines” seen when some people frown hard. When people grind their teeth and for certain ethnic groups, the masseter muscle is hypertrophied. This results in a squared jaw shape that is not as feminine as an oval or heart shaped face. Botox into this muscle can soften and reshape the square face. Finally, Botox can be injected into the platysma muscle of the neck and jaw line. This can lift the lower face and improve jaw line definition.

The results of Botox when injected into the lower face are not as dramatic as when the upper face is injected. For this reason, Botox is usually used to complement the effects of dermal filler.


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Our mission at the Lupo Center is to provide patients with innovative, effective and ethical care to make each person look and feel their personal best. To fulfill our goal, we provide state-of-the-art medical, surgical and cosmetic treatments to all patients.

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