Off-Label Botox Injections

Babak Azizzadeh, MD

Article by
Beverly Hills Facial Plastic Surgeon

Although Botox is most commonly used on the upper third of the face to smooth wrinkles, it also has very useful applications for the mid to lower third of the face.

Nose
The ‘bunny lines’ that can occur during speaking or smiling can be corrected with just a few units of Botox. 

Mouth
Botox can be used around the mouth to help prevent wrinkling when speaking or chewing.  A gummy smile (when the gums show too much when one smiles) can also be successfully treated with Botox.

Neck
Treating the vertical bands and platysma muscle in the neck can be successfully treated with Botox. 

Jawline
Sometimes the jawline can appear square to due enlarged masseter muscles, resulting from chewing, biting or grinding.  Botox can be used to treat this and results in a quick flattening of the muscle.  Often times, patients appear to have lost weight after receiving Botox in their masseters as their face appears ‘slimmer’.  This is a very commonly used approach for Asian and Hispanics.

Motor Nerve Dysfunction
Botox can also be useful in treating patients with facial asymmetry and nerve injuries such as Bell’s Palsy where one side of the face is paralyzed.  Botox can rebalance the asymmetry by weakening the nonparalyzed side of the face.  Getting the exact symmetry right can be challenging, and requires expertise.

Please note, Botox to the mid to lower third of the face requires extremely advanced skills and should only be performed by an expert injector.