DISCLAIMER: BOTOX is a prescription medicine and must be administered by a physician or by a qualified person under physician's orders. The best way to determine the area where BOTOX can or cannot be used is to visit a physician specializing in BOTOX injections for a consultation. This article is intended for general educational purpose only and cannot be used as a guide or recommendation for BOTOX or any other drug administration.

BOTOX injections are the most successful and most popular cosmetic procedures in the world. BOTOX has been used in medicine, including cosmetic medicine, for more than a decade and proved to be safe and very effective treatment for various conditions. In the cosmetic field BOTOX is used primarily for treatment of facial wrinkles. It is also effective for migraine prevention and to control excessive sweating (a medical condition known as hyperhidrosis)

People often get confused about what areas BOTOX can be used on the face, thinking that BOTOX can smooth any wrinkle. To make it clear, let's have a look at the most common wrinkles on the face. Surprise lines are horizontal creases on the forehead which are prominent when one tries to raise eyebrows.

Frown lines are often called "the number 11 lines". Those are the vertical lines between the eyebrows and they are prominent if one tries to frown.

Crow's feet lines are tiny lines which start from the outside angle of each eye and go toward temples in a fan-like fashion. Their shape resembles a bird's feet, it is unknown why crow was chosen, as it could have been a chicken, or a pigeon, or any other bird you like. Those lines are best visible when an individual is squinting.

Smile lines go from edges of the nose to the angles of the mouth. Visible when smiling, those can form pretty significant creases in some individuals. In medical literature they are called nasolabial folds, which is derived from Latin for nose-to-lip folds. Marionette lines go from angles of the mouth vertically down toward the chin. They resemble lines in marionettes, which are made to allow their mouth to move up and down.

Smoker's lines are fine vertical lines around lips. These lines are characteristic for people who smoke, as smoking requires them to pucker, which makes those lines more visible.

It is important to remember that BOTOX wrinkle smoothing happens as a result of muscle relaxation caused by BOTOX. BOTOX has no direct effect on the skin, it only acts on muscles. When facial muscles are active, they constantly pull the skin in different directions making wrinkles. By injecting BOTOX in specific muscles we can prevent or minimize certain motions.

When muscle activity diminishes and the skin does not suffer from constant motion stress, the wrinkles and lines in the skin begin to disappear. They disappear faster in well-hydrated and elastic skin of younger individuals, and require more time in older people.

As BOTOX works on muscles by relaxing them, the areas with a lot of muscle activity will benefit from BOTOX the most. However, the muscles affected by BOTOX should not be important for facial expressions or other vital functions or it may lead to unpleasant side effects like "frozen face", face droop or face asymmetry.

Surprise lines, frown lines and crow's feet are the most popular and successful areas where BOTOX is used. Smoker's lines may also be diminished by BOTOX injections, however, if a person is an active smoker, the effect could be very limited. It is because smoking promotes motion of the muscles responsible for creating these lines.

Smile and marionette lines, in turn, cannot be treated with BOTOX injections, as these lines are often deep even when facial muscles are at rest. If one tries to block the muscles responsible for smile or marionette lines, it could cause serious complications, like facial droop, but it will not make these creases to disappear.

BOTOX injections have also been used as off-label treatment to change the shape of lower face in people with heavy "square" jaw. This procedure is often called "BOTOX Jaw Line Contouring". Some people think that it can help to tighten sagging jaw skin. This is not true.

BOTOX Jaw Line Contouring is good only for individuals, usually of Asian descent, who have strong chewing muscles called masseter muscles. Injections of BOTOX make those muscles work less and they become thinner, making overall shape of the jaw less square. Note, even though this treatment has been discussed in international medical journals, it is still considered off-label and investigational.

BOTOX cannot tighten sagging or lax skin. If sagging skin is a concern, there are different cosmetic procedures available for skin tightening. One of them called IR Skin Tightening. It uses infrared light to tighten the skin.

BOTOX cannot stretch or remove wrinkles. Disappearance of wrinkles is a result of muscle relaxation caused by BOTOX injections.

BOTOX cannot fill hollow areas, like sunken cheeks or eye throughs. Dermal fillers can be used to fill wrinkles that are not good for BOTOX injections. Some other treatments, like Laser Skin Resurfacing, can also be used to diminish appearance of facial wrinkles.

To summarize, when considering BOTOX procedure for wrinkle release, it is important to consult with a physician specializing in BOTOX treatments. Generally, such areas as frown lines, surprise lines and crow's feet lines are considered as suitable areas for BOTOX. Areas like smile lines and marionette lines require different cosmetic treatments to effectively reduce visibility of folds and wrinkles.

TRADEMARK NOTES: BOTOX and BOTOX Cosmetic are trade marks of Allergan, Inc. Generic name of active component of BOTOX is OnabotulinumtoxinA

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