Alternative Uses for Botulinum Toxin

Botulinum Toxin (sometimes known as Botox®), is a neurotoxin that was first introduced for treating blepharospasm (uncontrolled blinking) and strabismus (lazy eye) in the late 1980s. Naturally derived from the bacterium Clostridium botulinum, the use of Botulinum Toxin has since dominated the world of aesthetic medicine through the reduction of ageing wrinkles in the glabella, forehead, and crow’s feet.

When injected into a muscle, Botulinum Toxin effectively blocks the electrical signalling the nerves that supply voluntary muscles. More specifically, the toxin inhibits the release of acetylcholine (the chemical messenger) from the nerve terminals at the neuromuscular junction. This results in the controlled reduction of muscle stimulation and a consequential relaxation of the zone treated.

Although its mainstay use has been for that of upper face wrinkles, the boom in non-surgical facial aesthetics has seen the development of Botulinum Toxin being used to treat and correct a variety of other cosmetic concerns.


Alternative Uses for Botulinum Toxin in Aesthetic Medicine

Chemical Brow Lift

The effects of gravity, ageing and the strong depressor muscles around the eye can all cause the brows to drop, resulting in sagging skin and a tired appearance. When injected into the depressor muscles around the eye, Botulinum Toxin relaxes the muscles, allowing the brows to lift up. This results in a more attractive and less tired look with clients reporting that the look fresher with a more open eye area.

Treatment of Gummy Smile

The term ‘gummy smile’ is used to describe the exposure of lots of gum in a full smile. A gummy smile is caused due to the upper lip elevating too far above the upper teeth, thereby exposing the gums and producing a smile which some deem to be cosmetically undesirable.

When Botulinum Toxin is injected into the muscle which elevates the upper lip the upper lip line lowers slightly to reduce the amount of gum displayed and lessen or eliminate the appearance of a gummy smile. In some cases, the appearance of a gummy smile can be aggravated by a thin upper lip. In these cases, dermal fillers can be injected to enhance lip volume and further soften the appearance of the gummy smile.

Reduction of Perioral Lines

Perioral lines are the linear wrinkles which radiate out from the border of the mouth. The lines develop due to activity of the underlying obicularis oris muscle and the loss of volume and elasticity around the mouth that often comes as a result of ageing. However, these lines are also frequently referred to as smokers’ lines as smoking often exaggerates their appearance.

Whilst dermal fillers can be used to reduce the appearance of perioral lines, Botulinum Toxin can also be injected into the underlying muscle to relax it and smooth the appearance of these lines. It’s worth noting that as Botulinum Toxin is administered very close to the lip, this procedure can result in problems with eating/drinking, smiling and talking if not performed by an experienced injector.

Chin Dimpling

Some people can develop a rough-textured appearance on their chin due to overactivity or chronic spasm of the chin muscles (mentalis). This dimpling may also be accompanied by excessive prominence of the chin. Hyperactivity of the mentalis muscle can also cause the chin to appear very narrow or bulbous and can lead to a heavy prominence of the mental crease (chin crease).

Injecting Botulinum Toxin into the mentalis muscle relaxes the muscle and therefore reduces the bulk of the chin. Much like when toxin is used to treat upper face wrinkles, it also smooths the surface texture and can soften the depth and appearance of the mental crease.

Masseteric Hypertrophy (Jawline Slimming)

The masseter muscle is one of the principal muscles of mastication (chewing) and connects to the mandible (lower jawbone) and the cheekbone. A hypertrophic (enlarged) masseter often occurs as a result of teeth grinding (bruxism) and can lead to headaches, accelerated rates of tooth wear and the development of a wide or squared jaw which is considered masculine.

As this type of jawline is not aesthetically pleasing to most people, Botulinum Toxin can be injected directly into the enlarged masseter muscle to reduce its bulk, slim the width of the jaws and restore balance to the face. Treatment can also reduce the traumatic impact of bruxism of the teeth and relieve symptoms of temporomandibular joint dysfunction.

Nefertiti Neck Lift

Inspired by the Egyptian Queen Nefertiti, this non-surgical neck lift technique is a popular choice for those who wish to correct the appearance of a ‘turkey neck’. With the loss of muscle tone, skin elasticity and subcutaneous fat that ageing brings, as well as the gravitational descent of the soft tissues of the face, the neck can become saggy and wrinkly. This results in an exaggerated jowling effect in the lower face. In addition to this, the muscular bands that extend from the jaws to the collar bones can also become more exaggerated.

When Botulinum Toxin is injected into muscles along the lower jaw line and into the neck area, it relaxes these muscles and allows opposing forces to lift the lower face. The saggy skin is pulled upwards, making it tighter and more taut. The result of the treatment is a contoured and youthful looking jawline and a reduction to the appearance of the jowls.


Hyperhidrosis, or excessive sweating, is a common problem that affects at least 1% of the UK population. The most commonly affected areas are the underarms, hands, feet or the face/head. The condition is not only inconvenient, but can cause social embarrassment and lead to detrimental effects on self-confidence.

Fortunately, Botulinum Toxin can be used to reduce the excessive sweating and improve the quality of life of people with hyperhidrosis. Botulinum Toxin works to block the stimulation of sweat glands, thereby reducing the amount of sweat produced. The treatment is performed via multiple small injections of the toxin being administered to the problem area.

Want to Learn How to Perform These Techniques?

As these treatments utilise advanced skills, they require strong foundation knowledge. All of the treatments listed above are taught during our CPD-certified Advanced Botulinum Toxin and Dermal Fillers course. This course is designed for those who to expand into more advanced methods of facial rejuvenation and many of them can be performed in conjunction with the treatments taught during our Foundation Botulinum Toxin and Dermal Fillers course.

When choosing a training provider for an Advanced Botulinum Toxin and/or dermal fillers course, make sure that the teaching is directed by surgeons who can share their detailed understanding of facial anatomy. In terms of the practical training offered, it is crucial that you practice treatments in small, intimate training groups with live model patients and gain as much hands-on experience as possible.

Find out more about our Advanced Botulinum Toxin® and Dermal Fillers course here.