Bala Cynwyd, PA
(610) 664-8830

Manhattan, NY
(212) 753-7400

Which Facial Areas Are Appropriate for Off-Label BOTOX®?

BOTOX® is a powerful microbial toxin that has a long history of use for both cosmetic and therapeutic applications. Since the early 2000s, when it was approved for glabellar lines, this breakthrough injection treatment has become the gold standard for diminishing hyperfunctional facial wrinkles. Basically, the injectable causes isolated muscles to relax, keeping wrinkles at bay. Specifically, when injected into particular facial muscles, it temporarily stops the activity that causes wrinkles to appear. It works by blocking the release of the neurotransmitter that initiates muscle contractions. Although Dr. Timothy Greco uses BOTOX® at his Bala Cynwyd practice for three FDA-approved applications (crow’s feet, glabellar lines, and forehead lines), experienced physicians like Dr. Greco also use their clinical judgment to inject it for other uses. Dr. Greco just published a chapter in a medical text as the lead author on the use of BOTOX® throughout the face and neck, Complications in the Minimally Invasive Facial Rejuvenation. Because the treatment is so versatile, physicians are constantly finding new applications for it.

The term “off-label” simply means that the medicine is used for a condition that has not been officially studied or approved for specific uses by the FDA. This is a perfectly safe and common way of using injectables. It’s up to the physician and patient’s discretion to determine whether the off-label use is the right choice in a given case.

BOTOX® is most often used off-label on the following areas:


Sometimes referred to as “Browtox,” the injectable can be used on the eyebrow area to lift and reshape brows, creating a brighter, fresher look.

Bunny Lines

The movements of facial muscles when you scrunch up your nose can cause diagonal wrinkles at the sides of the upper bridge, known as bunny lines. BOTOX® can smooth these out.

Gummy Smiles

BOTOX® relaxes certain overactive muscles so that the upper lip can unfurl, creating a more balanced smile that does not reveal as much gum show.

Lip Lines

Vertical lines around the mouth, which develop due to habitually pursed lips, can fade if the muscles are allowed to rest.

Marionette Lines

These are vertical lines that extend from the downturned corners of the mouth to the chin.

Dimpled Chin

A dimpled or “cobblestone” chin with an orange peel texture (peua d’orange) often occurs when the mentalis muscle is overactive, causing the skin to crease up because of the movement of the muscles below it. BOTOX® gives Philadelphia-area patients a youthful and refreshed-looking appearance by softening wrinkles and improving facial symmetry. Get more advice on this injectable and other cosmetic procedures available from Dr. Timothy Greco’s practice. Call us at (610) 664-8830 to learn more, or submit a contact form to request a consultation.

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