Botox is as close to a magic potion as anything can be in cosmetic dermatology and for its medical applications. Even the entire world supply of Botox is produced in an idyllic, seemingly magical town in Ireland called Westport.

The magic continues as many of these “wide smiles” may be attributed to this age defying elixir. After all, studies show Botox is a real mood booster.

With a population of about 5,500, Westport sits in the shadow of an ancient mountain, the end point of an annual pilgrimage, where Saint Patrick is said to have fasted for 40 days and 40 nights. It’s a town of brightly colored storefronts, tweed flat caps, and wide smiles.

Allure, November 2018

In cosmetic dermatology, Botox has FDA approval for use around and between the eyes (crow’s feet and glabella) and in the forehead. However, off-label uses of Botox provide us with the ability to do so much more:


Facial slimming and reshaping with Botox and chin filler is a beautiful thing. Botox injected into masseter muscles, the chewing and teeth clenching muscles located at the angle of the jawline, relaxes and reduces the size of this overworked muscle group. Botox injected into chin dimples or pebbled chin helps to smooth and elongate the chin.

Add a little filler for chin augmentation, and a broad square shaped face can be transformed into a feminine oval or heart-shaped one. Further, the slightest adjustments in chin length and projection provide serious improvement for most profiles and face shapes (aka. improved balance and proportion).

Interestingly, a by-product of lower face reshaping oftentimes gives lips a more voluminous appearance.


It’s quick. It’s easy. It’s natural looking. It may be all your lips need.

The lip flip is an off-label use of Botox to enhance the appearance of the upper or lower lips. A few units of strategically placed Botox in the superficial layers of the muscles around the mouth (obicularis oris) relaxes this muscle group enough to flip or roll lip edges outward and upward. Lips look naturally “poutier” than before.

The Botox Lip Flip is for you

if you want poutier lips

if your upper lip naturally disappears when you smile

if you want a subtly fuller looking lip without adding volume

if you want to maximize your lip filler with an added pout.

It may take up to a week to see full results. Results usually last 2-3 months.

A few more strategically injected units around the mouth can smooth lip lines (aka. BOTOX  for LIP/SMOKER’S LINES).

BOTOX NECK LIFT (aka. Nefertiti Neck Lift)

Botox works to flatten the vertical platysma muscles. Straining and stretching these muscles over the years cause them to detach and loosen. The edges of these platysma muscles protrude and appear as vertical bands from the chin to collarbone.

When small amounts of Botox are injected down these platysmal “bands” and along the jawline, the muscles relax, lifting and smoothing skin in the process.


Botox makes us smile for many reasons including lifting downturned corners of the mouth (oral commissures). This area becomes depressed over time, contributing to a perpetual frown and deeper marionettes. (Note: Deep marionettes oftentimes require filler as well as Botox.)

Botox relaxes the depressor muscles (DAO: depressor anguli oris), alleviating the depth of marionettes and up-turing frowny mouth corners.

BOTOX for HYPERHIDROSIS (Excessive Sweating)

Botox blocks the nerve signals (neurotransmission) to sweat glands. The result: little to no sweating, no need for an antiperspirant/deodorant and reduced dry cleaning bills.

Hyperhidrosis can occur in underarms, hands or feet. Botox is FDA approved for excessive sweating for underarms and is used off-label for hands and feet.


Botox injected into tensing muscles around incisions improves healing and minimizes scar width and appearance. Read this article from Dermatology Times and Allure.

BOTOX for PORES (MicroBotox, MesoBotox, PoreTox, Glass Skin)

Pores are passageways for hair follicles and sebum. Keeping pores clear of dead skin cell buildup and controlling the production of excessive sebum help in reducing the expansion of pores.

When pores become expanded, it is impossible to permanently reduce them again. However, intradermal Botox injections can temporarily shrink them and reduce oil production. Pore-Tox makes skin appear smooth and “glassy.”  Effects generally last between 3 and 6 months.

Other Off-Label Uses for Botox



For calves and shoulders, Botox works much like it does when used for masseter muscles (facial slimming). For calves, the gastrocnemius muscle is “de-bulked” with Botox. For shoulders, the trapezius muscles are reduced with Botox.



BOTOX for BUNNY LINES on nasal bridge


For the right candidate, Botox injected at specific points in the hairline can lengthen the forehead and smooth forehead wrinkles. Forehead skin feels “tighter,” not “frozen.” Brows may also appear to be lifted. 

This procedure is not recommended for patients with naturally long foreheads as the results may be undesirable (check out Margot Robbie as Queen Elizabeth I in Mary Queen of Scots).

Although there are seemingly endless cosmetic applications for Botox, it is important to understand that Botox is a medical procedure. Botox should only be injected by medical professionals in a medical environment.