Inject Me Where? — Yvon Lux

When most people think of Botox the first thing that usually comes to mind is wrinkle reduction. Indeed, Botox is the world’s most popular treatment for eradicating wrinkles and fine lines. The toxin is specifically FDA approved for treating frown lines between the eyebrows (glabellar lines) and lines around the eyes (crow’s feet).

In addition to being a popular choice for wrinkle reduction, Botox is also used to treat a variety of issues, both cosmetic and non-cosmetic. Dr. Stanley Poulos is a San Francisco area Board Certified Plastic Surgeon. He provides a list of conditions that Botox has been used to treat.

Acne

Botox can curb oil production, reducing breakouts. "To totally treat acne, you'd need to use doses of Botox so large they'd prevent you from constricting your facial muscles," says Dr. Poulos. "But tiny amounts of Botox injected very superficially help reduce oil production, and you can still have facial expressions." Though he'd recommend it for almost any patient struggling with acne, Poulos would likely advise trying another dermatologist-prescribed treatment, like spironolactone or birth control pills, first. And though it can technically be used to quell oil production anywhere on the face, he cautions against using it all over because of potential effects on muscular activity (a.k.a. frozen face). The most effective and common area for using Botox to curb oil production, he says, is the forehead.

Gummy smile (not FDA approved)

A "gummy" smile, one that's characterized by a smile that shows too much of the gums, usually results from "excessive lip elevation" when the upper lip rises too far above the upper teeth when smiling. Injecting Botox into the upper lip weakens the upper lip's retractor muscles so that it won't raise as high and your smile will seem better-balanced. It can be done in about five minutes. Usually lasts for four to six months. Costs range from $200-$300. Dr. Poulos says, "This technique is not for the novice Botox injector. Too much, and your lip won’t raise enough, too little and you will need more, or if injected asymmetrically, you might have a funny asymmetrical smile."

Urinary incontinence.

Overactive bladder problems affect up to 20% of women over 40. For severe cases where medications do not provide complete relief, Botox injections into the bladder wall may provide relief lasting about 6 months.

Psoriasis
Psoriasis is uncomfortable, itchy, and not exactly easy on the eyes. Luckily, this flaky skin condition could be a thing of the past thanks to Botox. Though psoriasis is technically incurable, Botox minimizes the activity of inflammatory cells that bring on outbreaks.

Excessive Sweating

For those who suffer from excessive sweating, however, summer isn’t always the sunniest time of the year. Thankfully, Botox could be a saving grace for those attempting to manage this condition, which is officially known as axillary hyperhidrosis. Studies show that just a handful of injections can reduce underarm sweat for up to TWO years. Um, where do we sign up?

Depression

The benefits of Botox® may be more than skin deep; two recent studies suggest that it may help alleviate the symptoms of depression. In a study published in the May 2014 issue of the Journal of Psychiatric Research, more than half of participants who had moderate-to-severe depression showed a substantial improvement in depressive symptoms following one injection of Botox® between the brows. This improvement lasts longer than the cosmetic effects, suggesting that the effect may be more than just feeling better about your appearance. Botox® is not approved to treat depression.

Teeth Grinding

Injections of Botox® were used to control involuntary muscle tension and spasms long before it became the go-to wrinkle buster. The neurotoxin injections may weaken the chewing muscles enough to reduce bruxism (teeth grinding) without affecting your ability to chew, talk and smile. Results last about four months. Botox® is not yet approved to treat bruxism.

Migraine Headache

Botox® is approved by the FDA to treat chronic migraine headaches in adults who have 15 or more headache-days a month, each lasting four hours or more. Studies that led to this indication show that BOTOX®® prevents up to nine headache-days a month (vs seven for dummy injections). Other research hints that the neurotoxin may also help with low cerebrospinal fluid headaches and cluster or "suicide" headaches.

Brow Boost

Much like lines form over time, your brow may also drop or droop. Botox cosmetic treatments can also be used to improve the appearance of the brow. The weakening muscles that pull the lateral brow down while selectively leaving the brow elevators intact can give a subtle lift and gives the brow more stability. Lifting the brows in this way leaves you with a less tired and younger, fresher appearance.

Jaw Reduction (off label use)

Botox can be used to perform jaw reduction (commonly called jaw line softening). Injecting Botox into the masseter muscle (the primary muscle used in chewing actions) reduces its overall size; transforming an overly square and masculine appearing jawline into a more feminine oval or heart shape.

Contributor:

Dr. Poulos is a Board Certified Plastic Surgeon and Co-Founder with Yngvar Hvistendahl, M.D of Plastic Surgery Specialists recognized as one of the premier aesthetic surgery clinics in Northern California.

Dr. Poulos helped pioneer the quick lift facial rejuvenation surgery in California and has extensive experience in body contour procedures. A graduate of the University of Texas Medical School, Dr. Poulos completed his internship and residency at UC San Francisco. He completed surgery and plastic surgery training in San Francisco prior to entering private practice in Marin County where he co-founded Plastic Surgery Specialists.