Body Contouring

More Than Wrinkles: 5 Surprising Uses for Botulinum toxin

20 June 2025

 

BTX/ Botulinum toxin- To most of us, BTX might be most famous as a neurotoxin injection for erasing wrinkles, but did you know that Botulinum toxin has far more medical applications? Botulinum toxin) has received US FDA approval for treatment of forehead frown lines, glabella wrinkles and crows’ feet wrinkles. However, did you know that BTX is also US FDA approved for treating hyperhidrosis (excessive sweating), overactive bladders and neck spasms?

 

In my last blogpost, I shared about one novel use of shoulder Botulinum toxin injections for shoulder slimming in South Korea. Today’s review on BTX injections will look at more surprising uses for botulinum toxin- from calf slimming to neck to protecting your teeth.

 

These treatments are considered to be off-label use of Botulinum toxininjections; which means that Botulinum toxin is used for a condition other than what the US FDA approved it for. This does not mean that Botulinum toxin injections in these cases are unapproved; it only means that the safety and efficacy of Botulinum toxin in these instances have not been fully established. Always remember that if you are seeking Botulinum toxin injections in Singapore, please choose a qualified and experienced doctor to ensure your safety and minimal risk of side effects.

 

Besides removing wrinkles and body contouring, there are many more uses for Botulinum toxin in Singapore. Some of these indications for Botulinum toxin are considered ‘off-label’.

 

What does ‘off-label’ use of Botulinum toxin/ BTX mean?

Off-label use of medications also does not mean that the use is illegal; in fact there are many common medications that have been used off-label. Once a drug has received US FDA approval for a condition, licensed doctors are allowed to prescribe the drug for medical issues that they think might benefit the patient. For example, Propanolol, a medication for treating hypertension, is used off-label to treat a complication of hyperthyroidism called thyroid storm. Another example would be the off-label use of antibiotics to treat rosacea.

 

Related blogposts:

Rosacea: Symptoms, Triggers and Treatments

5 Skincare Tips for Sensitive Skin and Rosacea

 

As with any medical treatment, it’s always best to consult your doctor about the safety and suitability before proceeding with Botulinum toxin injections. If you would like to read more about how Botulinum toxin works and the safety concerns surrounding Botulinum toxin, this blogpost Is BTX Deadly? 5 Things You Need to Know About Botulinum Toxin Safety will discuss the safety, side effects and complications of Botulinum toxin.

 

Here are 5 surprising off-label uses for Botulinum toxin injections in Singapore:

 

 

1. BTX Lip Flip/ Lip Lift

Before Kylie Jenner made full (some might say overdone) lips in vogue, Angeline Jolie’s iconic pout was widely coveted. Lip fillers have been the treatment of choice to plump up lips. Fillers used for lips are typically soft gels that contain hyaluronic acid which immediately add volume to thin lips. The downside of lip fillers? The dreaded duck lips or trout pouts look and lumpiness in the lips.

 

Related blogpost:

Lip Fillers Explained 

 

There are distinct differences in facial characteristics between Asians and Caucasians. Anthropological studies have shown that Chinese women have thicker upper and lower lips compared to their Caucasian counterparts1. Lip preferences also differ for different ethnic and cultural backgrounds. Although ideal facial dimensions cannot be generalised, it has also been shown Asians prefer smaller and thinner lips.

 

In the BTXLip Flip (sometimes also referred to as the BTX Lip Lift), botulinum toxin is injected into the muscles around the mouth (orbicularis oris muscles) to relax the muscle and flips the corners of the lip upwards. The lip flip gives the illusion of slightly fuller lips without actually adding volume into the lip.

 

The results with the BTX Lip Flip are also more subtle than lip fillers. If you’re considering less options that are less invasive than lip fillers for lip augmentation; the BTX Lip Flip is an alternative.

   

Victoria Beckham slaying with her toned legs.

 

2.  Calf Slimming i.e. Calf Reduction BTX

Another off-label treatment for Botulinum toxin is the slimming of bulky calf muscles. Botulinum toxin injections have been used to contour the leg muscles by causing controlled atrophy of the gastrocnemius muscle. An enlarged gastrocnemius muscle causes the calves to look bulky. Hence, by relaxing the gastrocnemius muscle with Botulinum toxin, muscles slim down for slimmer looking calves. The ideology of this is similar to Jaw BTX for slimming down the sides of the face and trapezius muscle Botulinum toxin injections to slim down the shoulders. You can learn more about this treatment in Calf Slimming/ Reduction with BTX.

 

Related blogposts:

Jaw Reduction BTX and Chin Filler Review

Shoulder Contouring with Trapezius BTX Injections

 

   

The bust of Queen Nefertiti. She was renowned for her beauty. Her long, slender neck and sharp jawline are immortalised in the Bust of Nefertiti.

 

 

3. The Nefertiti Lift

Queen Nefertiti was one of Egypt’s most famous queens renowned for her beauty. She was known as ‘Beauty of the Nile’ and her looks have been immortalised in a famous bust that depicted her delicate neck, slim jawline and arresting facial features.

 

The Nefertiti Lift is a non-invasive treatment that lifts and recontours sagging, banding and crepe-y skin along the jawline and neck. Small doses of botulinum toxin are injected into the platysmal muscle bands of the neck (i.e. turkey neck) and along the jaw to lift and tighten the skin and muscles. This also gives the neck and jawline a sharper and slimmer silhouette a la Nefertiti.

 

The Nefertiti Lift can be combined with Dermalift, where Microbotox is used to lift the skin.

Related blogposts:

Is Hybrid Cooperative Complex Injectable Moisturiser the Injectable Skincare of the Future?

 

Model Chrissy Teigen sharing her experience getting underarm Botulinum toxin for hyperhidrosis on her Instagram stories.

     

4. Hyperhidrosis (Excessive sweating)

Excessive sweating is a medical condition called hyperhidrosis. Botulinum toxin blocks neurotransmission to sweat glands to reduce sweating. BTX has received US FDA approval for treatment of axillary hyperhidrosis in 2004; however treatment of excessive sweating in the hands and feet with Botulinum toxin is off-label.

   

Some of the non-surgical treatments for a slimmer nose are nose thread lifts, nose fillers and botulinum toxin.

 

5. Botulinum toxin for a slimmer nose

 

Non-surgical nose enhancement is a popular request in Singapore.  Nose fillers is a common option for achieving a slimmer nose bridge and nose tip.

 

However, if you have a wide nose due to nostril flaring when you laugh or smile, BTX  into this muscle, the sideways pulling action of the nose is lessened.

 

Related blogposts:

5 Things You Need to Know About Nose Fillers

BTX vs Fillers: Differences, Effects and Myomodulation

 

   

Conclusion on off-label uses for Botulinum toxin

There’s a lot more to BTX than removing wrinkles. Some of these uses for BTX are considered as off-label as US FDA approval has not been given yet. If you enjoyed this review on off-label uses of BTX, you might enjoy the following BTX related blogposts:

Too Much BTX:Botulinum toxin Gone Wrong

Bruxism: Causes, Symptoms and Treatments

Preventive BTX and Baby Botulinum toxin in Your 20’s Is Real

NoTox: Non-Invasive Botulinum toxin Alternatives

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