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A guide to less commonly known Botox applications — nose tip lift, gummy smile correction, neck bands, lip flip, jaw slimming, and other off-label uses that experienced injectors offer.
· By MedSpot Editorial · 6 min read
#injectables · #botox · #face · #guide
Most people know Botox treats forehead lines, frown lines, and crow's feet. Those three areas account for the majority of neuromodulator use. But experienced injectors use Botox across more than a dozen areas — some FDA-approved, many off-label — to address concerns that patients didn't know were treatable without surgery. Here's a guide to the less obvious applications.
For reference, the FDA-approved cosmetic indications for Botox specifically:
Everything below is off-label — legal to offer and perform, but not supported by FDA-approval for that specific indication. Off-label Botox has an extensive evidence base from clinical studies and decades of practice.
What it treats: The depressor septi nasi muscle attaches the nasal tip to the upper lip. In some patients, this muscle actively pulls the tip downward when they smile or speak — the nose "drops" or "elongates" with animation. This is called dynamic tip ptosis.
Treatment: 2–4 units of Botox injected into the depressor septi nasi relaxes the downward pull. The nose tip maintains better position during expression.
Who benefits: Patients who notice their nose tip appears to elongate or drop when they smile, often visible in candid photos. Patients with a nasal base that appears wide on smiling (the alar base flares with smile) can also benefit.
Who doesn't benefit: Patients with static tip ptosis (tip drops at rest, not just with animation) — this is a structural issue that Botox cannot address.
Dose: 2–4 units total (very small); precise placement is essential.
Cost: $100–$250.
What it treats: When smiling, some patients show an excessive amount of upper gum above the upper teeth. This is caused by hyperactivity of the levator labii superioris alaeque nasi (LLSAN) — the muscle that elevates the upper lip. When it contracts too strongly, the lip rises higher than typical.
Treatment: 2–4 units per side into the LLSAN reduces excessive lip elevation on smiling.
Dose and care: This is a technically precise injection — too much product or incorrect placement can cause an asymmetric smile or excessive lip ptosis (the lip droops too far and covers the teeth). 2 units per side is conservative; adjust at 2 weeks if needed.
Duration: 3–4 months.
Cost: $150–$400.
Note: Some gummy smiles are caused by skeletal issues (vertical maxillary excess) or by excess gum tissue — Botox does not address these structural causes. An assessment by the injector (and potentially a dentist or oral surgeon) is appropriate before treatment.
What it treats: Vertical cords that run down the neck — caused by the platysma muscle becoming more prominent with age. See our neck rejuvenation guide for the full context.
Treatment: 20–60 units distributed along the platysmal bands. This relaxes the downward pull of the platysma, which also provides mild lifting of the lower face and jawline.
Duration: 3–4 months.
Cost: $300–$700.
Covered in full detail in our masseter Botox guide. Summary: 50–100 units total into the masseter muscles for aesthetic jaw slimming or bruxism treatment. Duration 4–6 months for function; 6+ months for aesthetic slimming.
Covered in our lip flip guide. 4–6 units into the orbicularis oris to roll the upper lip outward. Duration 4–8 weeks — the shortest-lasting Botox application.
What it treats: Brow position and shape can be adjusted with Botox beyond the standard glabellar treatment.
Dose varies: This is one of the more nuanced applications — the relationship between the frontalis (brow elevator) and the orbicularis/corrugators (brow depressors) determines how the brow positions. Small doses in the wrong place can produce unexpected results.
Covered in our hyperhidrosis guide. FDA-approved for axillary use; off-label for palms, feet, and scalp. Duration 6–12 months — the longest-lasting Botox application.
What it treats: Fine vertical lines radiating above the upper lip, caused by repeated orbicularis oris contraction (pursing, speaking, drinking from straws).
Treatment: Very small doses (0.5–1 unit per line or 1–2 units per injection point) placed along the lip border. Requires very conservative dosing — too much relaxes the lip seal and causes functional issues (difficulty with straws, certain speech sounds).
Best combined with: Topical retinoids, laser resurfacing, or soft filler for deep lines. Botox prevents the muscle from deepening lines further; it doesn't fill or resurface existing damage.
Duration: 3–4 months.
Cost: $100–$300.
What it treats: The mentalis muscle (chin muscle) can create an "orange peel" or cobblestone texture on the chin with animation — small dimples and bumps visible when the person speaks or moves the lower lip.
Treatment: 4–8 units into the mentalis smooths this texture.
Duration: 3–4 months.
Cost: $100–$250.
What it treats: The depressor anguli oris (DAO) pulls the corners of the mouth downward, creating a resting "frown face" appearance even when the patient is neutral.
Treatment: 2–4 units per side into the DAO allows the mouth corners to rest in a more neutral position.
Care: Over-treatment can cause asymmetric smile or difficulty controlling the lower lip. Conservative initial dosing (2 units per side) with touch-up at 2 weeks is the safe approach.
Duration: 3–4 months.
Cost: $150–$400.
Experienced injectors often address 4–6 areas in a single session — combining forehead/glabella/crow's feet with small-dose treatments for the lip flip, DAO, chin, and brow shape. This "full-face neurotoxin" approach uses each modality where most appropriate and produces a harmonized, refreshed result.
Typical total dose for a full-face protocol: 60–120 units for women; 80–150 units for men.
Looking for an experienced Botox provider near you? Browse injectable providers on MedSpot →