Neurotoxin injections—which many refer to as Botox Cosmetic, but let’s not forget Dysport, Xeomin and Jeuveau—are known for their ability to relax the facial muscles that lead to forehead wrinkles, crow’s feet and glabella lines. But that’s not all these wrinkle relaxers do as expert injectors continue to find ways that neurotoxins can help treat or reshape other, less talked about areas. Here, top doctors share some surprising off-label places they inject this skin-smoothing treatment.
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Nightly teeth-grinders can benefit from the injectable’s ability to stop grating teeth in their tracks, but many patients love the slimming side effect. “I inject in the massater muscles for teeth grinding to cosmetically thin the face and provide a more pleasing aesthetic heart-shaped face,” says Fort Lauderdale dermatologist Dr. Matthew Elias. “It’s also very effective across face for pore size and sweating anywhere on body.”
According to New York dermatologist Doris Day, MD, the temples can also be injected to treat clenching and also for face shaping. “The temporalis muscle is part of the group of muscles you use for chewing, called muscles of mastication. They can become overgrown from clenching and grinding which can make the face shape look odd and can cause awful headaches as well. Botox carefully done in this area can relieve pain and restore balance to the face.”
Off-label injections of neurotoxin in the chin can help correct a dimpled, textured look, says Davie, FL dermatologist Marianna Blyumin-Karasik, MD. “It really helps to reduce that peau d’orange bumpy-lumpy chin look.”
“The platysmal bands in the neck can be injected for reduction of the appearance of the bands, making the neck appear smoother,” advises Rochester, NY dermatologist Lesley Loss, MD. “I also like to use it to create a more defined jawline and a thinner appearance to the lateral face. And lastly, you can inject neurotoxin into the armpits, hands and feet for hyperhidrosis.”
Bloomfield Hills, MI dermatologist Linda C. Honet, MD notes that recent studies have shown possible effectiveness to reduce the formation of new surgical scars and to improve old keloidal and hypertrophic scars on the face. “Treatment approaches range from direct injection into a fresh wound margin, to injection into a long-standing scar itself, to injection into the surrounding musculature. The reduction of opposing muscle movement prohibits healing wounds from stretching, but there are also numerous other mechanisms where neurotoxin potentially affects cell signaling, cell differentiation, molecular processes, and the inflammatory cascade that may all affect scar formation,” explains the doctor.
“I use neurotoxin injections a lot at the base of the nose to relax the nasal tip and let it go up,” adds West Palm Beach, FL dermatologist Kenneth R. Beer, MD. Fresno, CA dermatologist Kathleen Behr, MD adds that she uses three to four units of the injectable to treat “bunny lines” that often form on the nasal bridge.
The days of the Kylie Jenner-style lip filler seems to be waning, with many patients preferring a subtle lip boost using neurotoxin called a lip flip. “When neurotoxin is used alone, or in combination with fillers, it can give lips a pout-magnification by flipping out the lip line—rolling the lip gently outward giving the appearance of fuller lips,” explains Saddle Brook, NJ dermatologist Dr. Frederic Haberman.
“It can also be injected on the upper lip for smokers lines and also to help with a gummy smile,” adds New York dermatologist Julie Russak, MD.
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