Botox:  Beyond The Wrinkle

Most people associate Botox treatments with wrinkles, but what most people don’t know is that age prevention is just one of the countless uses for the injectable. Botox is actually used for a variety of treatment options including migraines, excessive sweating (hyperhidrosis), Bell’s Palsy, thyroid eye disease, various bladder disorders,  drooling (hypersalivation), TMJ disorders (masseter reduction), droopy nose tip, lip flips, and gummy smiles. 

For the purpose of this article, we will discuss cosmetic procedures with Botox that are less commonly known but provide subtle yet incredible results. 

To start, let’s review what Botox is and how it works. Botox is a neurotoxin. The neurotoxin targets the nervous system, disrupting the nerve signaling processes that stimulate muscle contraction. 

In order for any muscle to contract, the nerves release a chemical called acetylcholine at the junction where nerve endings meet muscle cells. Acetylcholine attaches to receptors on the muscle cells and causes the cells to contract, or shorten.

Botox injections in small controlled doses prevent the release of acetylcholine, which stops the muscle cells from contracting. This is how the drug causes temporary paralysis leading to localized muscle relaxation.

To learn more, you can read our previous blog which goes into more details about Botox. 

The cosmetic botox treatments which are quickly garnering more attention are as follows:


A lip flip involves using Botox to enhance the upper lip. An average of 4 – 6 units of Botox is injected into various areas of the upper lip to help to relax the muscle and allows it to roll slightly upward, which allows the upper lip to be more visible and defined. This muscle relaxation can also help smooth vertical lines around the lips that can occur with aging. This is also a great alternative for people who are debating lip filler but are not quite ready to make the commitment. It is also a much cheaper alternative. A lip flip can also be combined with lip filler to enhance the look of the lip filler and optimize the appearance of the top lip. Surprisingly, doing a lip flip can actually help to improve gummy smiles and are often done together. Most patients can notice the effects within a few days of treatment but maximum results can take up to 2 weeks. The effects of Botox on the lips can last upwards of 3 – 6 months. 


Often used in conjunction with a lip flip, the correction of the gummy smile is quickly becoming one of the most commonly requested after anti-wrinkle treatment. Gummy smiles occur due to a hyperfunction of the muscles involved in smiling which reveals too much gum tissue above the top of the teeth.  Botox is often the first choice of treatment for a gummy smile and usually requires an average of 2– 4 units of Botox on either side of the nose, commonly known as the Yonsei point. Treating this area causes a relaxation in the muscles, lowering the upper lip giving a less gummy appearance. The effects of Botox for the gummy smile is the same as a lip flip and can last upwards of 3 – 6 months. 


Hyperhidrosis is abnormally excessive sweating that is not necessarily related to heat or exercise. It is most commonly caused by overactive sweat glands. This can disrupt your normal daily activities and this type of heavy sweating can cause social anxiety and even embarrassment. Believe it or not, Botox injections can be used to treat this. It blocks the nerve signals responsible for activating the sweat glands, stopping the sweat glands from producing too much sweat. Botox has been FDA-approved to treat armpits, however it can also be used “off-label” to reduce sweating in other areas such as hands and feet. Typically 50 units under each arm are administered for optimal results. Botox is a highly effective treatment and for many people, drastically improves their quality of life. 


The droopy nose tip is the most common reason why patients might seek out non-surgical nose jobs with Botox. This is caused by the depressor septi nasi muscle, which increasingly pulls the nose down from the upper lip as we age. To treat the droopy nose tip, an average of 2-4 units of Botox right underneath the septum of the nose. This paralyzes the depressor septi nasi muscle, resulting in the nose having a lifted and lighter look. 


This specific treatment area carries a lot of benefits and has increased in popularity over time. Masseter Reduction is done by injecting Botox into the masseter muscle on either side of the face. It can help to relax the jawline area giving the appearance of facial slimming and in addition, prevent you from clenching and grinding your teeth. This is especially helpful with those suffering from TMJ. It is done by administering Botox into 3 areas of the masseter muscle. Masseter Reduction typically required anywhere from 30 – 60 units of Botox. 

Botox for masseter reduction is an “off-label” use that refers to using medication for something other than what it was approved to treat. It is not a long term solution for TMJ, so it is best to discuss with your provider the benefits and risks of this procedure and if it is right for you.

In summary, the effects of Botox vary from person to person and results may vary. Typically you can expect Botox to last anywhere from 3 – 12 months depending on the persons’ response and metabolism. All the procedures above have minimal to no pain and do not require any downtime. Make sure to discuss all your options with your provider to find the best treatment for you.

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