Botox has been safely injected into the upper face for over ten years. It gained FDA approval to decrease the appearance of frown lines in 2002 and the crows feet in 2014. The horizontal lines of the forehead will likely be next. But what other muscles can we target and what will it accomplish?
The Masseter- The Masseter is a muscle located at the angle of the jaw. It is the largest muscle of the face and is one of the muscles used in mastication (chewing). Botox is injected into this muscle in order to slim the jawline changing the appearance of the lower face from round or square to more of an upside down triangle. Botox paralyzes the muscle and with time the muscle atrophies or shrinks in size. Think of this as the opposite of working out. When you lift weights with your arms, your biceps and triceps grow and when you stop lifting for a couple of months your muscles return to their baseline size. Now imagine you break your arm and have to put it in a cast. A couple of months later, when the cast is taken off, you’ll likely notice the muscles of the affected arm are smaller than those of the arm you did not break. This phenomena is known as ‘disuse atrophy’ and Botox placed in selected muscles, for instance, the Masseter, can have the same effect.
Nasalis- the Nasalis muscle covers the bridge of the nose. Contraction of the Nasalis leads to elevation of the nose and the appearance of ‘bunny lines’. Botox can prevent this contraction and erase the bunny lines.
Levator Labii Superioris Alaeque Nasi and Levator Labii Superioris- have you ever noticed when some people smile you see a lot of their upper gums? This is called a ‘gummy smile’. It is defined as a smile that shows more than 2 millimeters of upper gums and is the result of hyperactive levator labii superioris alaeque nasi and levator labii superioris. A little bit of Botox in the right anatomical area can soften the smile and keep the gums hidden behind the upper lip.
Depressor Anguli Oris- the Depressor Anguli Oris is a muscle responsible for pulling down the corners of our mouth. As we age the corners of our mouths tend to drop and can give some patients the appearance of a permanent frown. Botox can help reverse this by paralyzing one of the muscles responsible for it. The results are a slight upturn of the corners of our lips and a softened appearance of the lower face.
Mentalis- close your mouth and blow out inflating your cheeks. You may notice some dimpling of the chin. Some patients have these small dimples throughout their chin even when not making this face. They are the result of a muscle called the Mentalis and Botox can decrease their appearance.
Platysmal bands- the Platysma is a thin muscle that covers the front portion of the neck. Often times a segment of the muscle will enlarge and stick out creating a vertical band stretching from the chest or shoulder area to the jaw. Botox can be injected to soften these bands and return a smooth appearance to the front of the neck.