Can Cosmetic Botox and Medical Botox Both Be Used?

I currently get 100 units of medical Botox in my neck every 3 months for Essential Tremor/Dystonia. I would like to use cosmetic Botox for my frown lines, but am concerned about antibody build up. Would this be an issue? Thank you.

Doctor Answers 14

Botox on frown lines

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I think it would be ok to inject your frown lines every 4-6 months with 20 units of botox. I wouldn't want to use a whole lot more than that in addition to your 100 units every 3 months.

New Orleans General Surgeon

Botox Cosmetic is the same as medical Botox

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Botox Cosmetic is the same as medical Botox. Fortunately, antibody build up is uncommon. Getting a few additional units for frown lines will help smooth your facial wrinkles.


Dr. Chaboki


Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

BOTOX and BOTOX Cosmetic Are Identical

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BOTOX and BOTOX Cosmetic are exactly the same formulation of botulinum toxin type A (onabotulinumtoxinA); they are manufactured in the same plant, have the same molecular weight, and are packaged as 100 Units of toxin per vial. The differences are not related to marketing, but instead FDA approval.

BOTOX is approved for abnormal twitching of the eyelid, muscle stiffness and contraction in the neck, chronic migraine headaches, overactive bladder due to neurologic disease, strabismus (a condition in which the eyes are not properly aligned), upper limb spasticity, and severe underarm sweating. 

BOTOX Cosmetic is approved for moderate to severe frown lines between the eyebrows.

Antibody formation should not be a concern. Many patients are treated with more than 100Units of BOTOX and have no problems. In my practice, some patients receive BOTOX Cosmetic for their frown lines and other facial areas, and also have their underarm sweating treated. These individuals may receive about 120 -170 Units for the treatment of all these areas and have had no problems; this would be similar to what you are asking about.

Be sure to seek an experienced injector who purchases their BOTOX from the manufacturer (Allergan); this ensures you are receiving the genuine product.

Best wishes, Ken Dembny

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 36 reviews

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Can Cosmetic Botox and Medical Botox Both Be Used?

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 Botox is Botox, whether it's from Botox Cosmetic or medical.  Antibody formation is unusual and has not resulted in decreased effects of future Botox injections IMO. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

The products are identical and the risks minimal

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Whether you use 100 units every three months or say 150 units, should not significantly change your likelihood of developing antibodies. In any case this risk is very very low. 

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon

Botox Medical vs. Botox Cosmetic

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Just as my colleagues have said below, they are one in the same. Always make sure you go to a reputable facility that uses Botox by Allergan and not some bootleg version.

Can I get Botox for medical and cosmetic reasons at the same time

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The products are the same but marketed differently. I would also remind you that lots of people are treated for Botox for cosmetic purposes in the face, at the same time they get Botox for underarm sweating. I do both of these types of treatments for many, many of the same patients and have not had any seem to be more or less likely to have antibody problems (which only occurs in a very, very, very small percentage of users). So using Botox for ET/Dystonia, as well as for cosmetic purposes would be much the same dosing and therefore wouldn't have any further causation towards problems with antibodies.

Cosmetic Botox and "Medical" Botox are the same, just packaged differently due to FDA guideines

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Both Cosmetic Botox and "Medical" Botox are exactly the same.  If worried about developing antibodies, it is recommended to get both injections on the same or very close to the same day.  It is rare to get antibodies to Botox, but if you did, Dysport and Xeomin are alternatives to use.  I have found that some people respond less and less to Botox after getting it for years and when treated with Dysport, they do better.  I have never tested for antibodies because it's a fairly expensive blood test.  I just try the alternative.  Theoretically, you shouldn't develop antibodies to Xeomin because it doesn't have an associated protein which antibodies develop against.

Steven F. Weiner, MD
Panama City Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Cosmetic and medical Botox

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These are the same products just labelled differently and as long as your physician has expertise with Botox you should be fine in regards to your treatment results. Any untoward effects should be discussed with your surgeon.

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

Cosmetic and Medical Botox

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Cosmetic Botox and Medical Botox are the exact same product and work the exact same way.  The product has different names solely for marketing purposes. Therefore, the "medical" botox that is used to inject your neck is the same as "cosmetic" botox used to treat fine lines and wrinkles. Although it has been reported, developing antibodies to Botox is rare. Thankfully there are a number of other products (such as Dysport and Xeomin) that can be used if antibodies develop.

Adam J. Mamelak, MD
Austin Dermatologic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.