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Beyond Frown Lines: The New Botox® Treatments You Need to Know About

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This year marks 16 years of Botox on the market as an FDA approved cosmetic solution for dynamic wrinkles on the face and facial treatment. With continued use, practitioners have found new uses and applications for this miracle injectable. Off-label Botox treatments have skyrocketed in popularity in recent years, especially with millennials looking to prevent signs of aging sooner rather than later. At Reflections Center, we are always looking for new ways to use existing treatments and incorporating the latest aesthetic trends into our service offering.

Are “off-label” Botox treatments safe and effective?

Believe it or not, Botox has been used off-label probably more frequently than on-label over the past 16 years, and we know that in the hands of a well-trained and experienced injector, Botox is completely safe. That’s why at Reflections Center, all our injectors are highly-trained cosmetic physicians.

Here’s the timeline of Botox FDA Approvals for wrinkle treatment:

  • 2002 – Botox is approved for the cosmetic correction of lines created by the glabellar muscle or the “11’s” between the brows
  • 2013- The treatment of ‘‘crow’s feet’’ lines at the outer corner of the eyes is approved
  • 2017- Botox is approved for treating moderate to severe horizontal forehead lines above the brow

Reflections Center physicians were using Botox for crow’s feet and horizontal foreheads lines almost from the beginning — these FDA approvals just solidify and codify what studies and anecdotal evidence had already told us.

To answer the question “are “off-label” Botox treatments safe and effective?”, it depends on one thing: your injector. The training your injector possesses regarding Botox as well as their understanding of anatomy, will ultimately determine if your treatment will be safe and effective.

What new applications do Reflections Center have for Botox?

The CEO of Allergan (the makers of Botox) once referred to the injectable as a ‘Russian Doll’ due to its multiple uses. Botox has been found to be effective for cosmetic and medical reasons alike, subsequently increasing its popularity among a wider demographic. The following are some of the ways Reflections Center is uniquely using Botox.


MicroBotox is one of the newest Botox uses in the aesthetic industry with an entirely new purpose: reducing redness and shrinking pores. Redness and large pores have long been obsessions among patients longing for perfect skin, and both concerns had long been looked at as untreatable.

MicroBotox is performed using a microneedling system called Aqua gold FineTouch®. This system intentionally places the Botox in the top layers of the skin in order to shrink pore size and reduce any redness caused by overactive capillaries or rosacea.

To take the treatment a step further, MicroRejuve was developed using the same system with Botox but also administers hyaluronic acid, a revitalizing skincare ingredient that plumps the skin, smooths fine lines and refines pores.

Botox for Hyperhidrosis

Hyperhidrosis is a condition in which the sweat glands are overproducing sweat to the point in which the individual is physically and emotionally uncomfortable. However, with Botox injections, a patient can experience dry comfort for up to nine months when treated. The purified protein in Botox disables the sweat glands from receiving the signals that trigger perspiration.

Botox for Migraines

One of the most exciting new applications for Botox is not actually cosmetic. Doctors have found Botox effective for treating these debilitating headaches. For patients suffering from more than 15 headaches a month, they can finally find relief with this quick treatment. Botox injections are administered by one of our physicians into various points on the forehead, temples and upper neck.

Are there other injectables or skin treatments that are complementary to Botox?

Botox helps to stop the repetitive muscle motions that cause wrinkles by decreasing the intensity and frequency of those muscles’ contractions. The skin will naturally smooth itself out as it’s given time to recover without as much wear-and-tear from repeated muscle contractions. However, where damage is severe enough, wrinkles and lines will not completely disappear from Botox alone.

To treat static lines such as these, you can use dermal fillers to strengthen the skin’s elasticity (through the growth of new collagen and elastin fibers) and by increasing the resistance against the muscle’s contractions. Fillers also make a perfect solution for plumping up the deepest of wrinkles and creating a smoother surface.

For those that have significant skin laxity and sun damage, Botox and fillers won’t make nearly as big of an impact on their own as when they are paired with laser skin resurfacing or RF Microneedling.

What are the most common patient concerns about Botox at Reflections Center?

The number one concern we hear from patients is the fear of looking unnatural.  To prevent this, we listen to what the patient is concerned about and then use our understanding of the aging process and anatomy to discover what the underlying causes of these concerns are, and that’s what we ultimately treat.

With Botox, that’s often looking completely frozen or in a constant surprised state with too-high eyebrows. For best results, we take things slow the first time and take the time to understand your unique anatomy before we inject. Good Botox is not a one-size-fits-all treatment.