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Botox (a brand name), is botulinum toxin, a drug made from the bacterium Clostridium botulinum. Other brands for this includes Dysport, Xeomin and Neuronox (Korean). It is used to prevent wrinkles and for a slimmer, v-shaped face / jaw reduction at aesthetic clinics in Singapore.

Botox, Dysport and Xeomin
Botox, Dysport and Xeomin

But do you really know how it works and how it achieves the different results on different areas of the face? 

Briefly – How does Botox work?

Botulinum toxin works by inhibiting muscle movement. To be exact, it prevents nerve impulses from being transmitted from the brain to the muscles. These impulses travel through our nervous system and crosses from nerve to nerve at junctions called the nerve synapses. 

Botulinum toxin targets and blocks nerve synapses, therefore breaking the message chain. Without this message from the brain to the muscle (or any other body part), the muscle will not receive the instructions to move.

More toxin = more movement inhibited (more nerve synapses blocked) = more of a “frozen” look.

 “I use it very sparingly. I want to look natural.” – Vanessa Williams

For lines and wrinkles (such as the ones on the face and forehead), we usually start with small doses to help prevent dynamic lines from forming. 

For facial slimming / jaw muscles, botox works by first preventing movement, then eventually the masseter muscle shrinks with the lack of usage and this leads to a sharper, smaller face! 

Botox can also be used on and for… 

Skin Botox or Micro-botox

Meso / Baby / Skin Botox for glass skin
Baby Botox / Skin Botox for Glass Skin?

An extremely popular treatment in South Korea, Skin botox is when one gets multiple small injections of diluted botox into the face.

The botulinum toxin works by blocking the nerve impulses to the sebaceous glands and sweat glands on the skin, which reduces oil production and sweat from the face. This in turn reduces clogged pores and minimizes pore size. It also as the additional effect of prevent acne, brightening the skin, and improving skin texture!

How soon can you see results for skin botox: 3-5 days to work
How long does skin botox last: 6 months
Units of botox required for the whole face: 30-40units for whole face. Some combine it with hyaluronic acid (skinboosters).

Note: It is also known as “Baby Botox” or the AquaGold Facial!

Underarms and palms to prevent excessive sweating

Hyperhidrosis, or sweaty palms and underarms, can be treated very effectively with botox. Botulinum toxin reduces sweating by blocking the nerve impulses to the sweat glands in our skin. Inhibited sweat glands greatly reduce the amount of perspiration.

How soon can you see results for botox to treat excessive sweating: 3-5 days to work
How long does botox for excessive sweating last: 6 months
Units of botox required to treat excessive sweating: Depending on the area treated – the larger the area, the more required as there are more sweat glands. On average, about 40 – 50 units for each arm or palm.

Note: Botulinum toxin administered for excessive sweating does not affect muscle movement as administered into the skin layer instead of the muscles. However, it is again important to go to an experienced doctor as the skin layer and muscle layer are very close together and incorrect technique can lead to unwanted side effects.

Calf muscle reduction

Calf botox
Overly muscular calf muscles?

Calf botox is a popular treatment in Korea and a growing request in Singapore. When done on overly muscular calves, it helps to achieves a more feminine curve, making legs look slimmer and longer.

Calf muscle reduction works exactly the same way as how botulinum toxin works for jaw muscle reduction. Calf muscle activity is reduced and restricted, and calf muscles becomes weaker and smaller over the next few weeks. It is akin to how a bodybuilder loses muscle mass after some time if he stops training his muscles.

How soon can you see results for calf botox: 4 weeks as it takes time for muscle size to reduce once the botox is administered
How long can calf botox last: 6 – 8 months
Units required for calf botox: More as calf muscles are bigger – an average of 75 – 100 units per calf muscle.

Note: Too much botulinum injected into the wrong areas in the calves can result in over weakening and one may experience weakness even when walking.

Shoulder contouring

How shoulder botox works

Botulinum injections for shoulder contouring aims to achieve a lean, elegant, and more angular shoulder line, especially for women wearing tubes or strappy dresses. Due to over usage of mobile phone (text neck) and long office working hours, some people can develop a poor posture, which leads to overdeveloped trapezius muscles – masculine, rounded shoulders. 

Like calf and jaw muscle reduction, shoulder contouring aims to reduce the size and bulkiness of the trapezius muscle. The trapezius muscle is a muscle that connects the neck and the shoulders and is often the area that feels stiff due to poor posture. For those suffering from stiff and aching shoulders, shoulder contouring has the additional effect of removing these aches!

How soon can you see results for shoulder botox: 3-4 weeks for muscles to shrink
How long does shoulder botox last: 6 – 8 months
Units required for shoulder botox: An estimated 30 – 50 units per side of the trapezius muscle

Note: As with all off-label botulinum toxin procedures, visit an experienced doctor you trust as there can be unwanted side-effects such as a droopy shoulder if too much is administered into the wrong areas.

Gummy smile Botox

Jennie, Miley Cyrus and Nicole Kidman with gummy smiles
Celebrities with gummy smiles (some had them fixed!)

Showing too much gum when you smile? Yes, a bit of botulinum toxin (and sometimes lip fillers along with this) can change your smile! 

A gummy smile happens for some individuals because of the overactive muscles that pull up our upper lip when we smile, causing your upper lip to look thinner than it is and therefore overexposing the upper gums.

Botox works by relaxing and reducing the movement of the upper lip muscles. Once these muscles are relaxed, the upward pull of the lips is reduced and less of the upper gums are exposed. 

How soon can you see results for gummy smile botox: Results are quick, usually within 3-5 days, as the relaxing effects of botox sets in. 
How long does it lasts: 4 – 6 months, as the lips are often used.
Dosage required for gummy smile botox: Only a small amount of botox is required, between 5 – 10 units. 

Note: Too much botulinum toxin administered to the smiling muscles can result in a crocked smile or a reduced smile. If you have too much gum to teeth ratio, speak to a dentist on options to contour your gums!

Oily scalp Botox

An oily scalp is caused by overactive oil glands in the scalp, or infrequent washing of our hair. Excessive oil attracts dirt more easily, possibly causes dandruff, gives off an odour and sometimes cause folliculitis (infection of hair follicles).

Botulinum injections reduces oil production on the scalp like how sweat production can be reduced on palms and underarms. Botox, when administered into the skin of the scalp, reduces the activity of the oil glands dramatically. 

How soon can you see results for oily scalp botox: 3-5 days
How long can it last: Usually lasts 6-8 months.
Units required for oily scalps: The amount of botox needed usually ranges between 35-60 units for the whole scalp. 

As there is minimal muscle on the scalp, side effects for botulinum toxin scalp injections are minimal. Administered to the scalp and the back of the neck, tension headaches/migraines can be reduced as muscles responsible are relaxed. Compared to the underarms and palms, the procedure is slightly more uncomfortable as numbing cream application is more difficult.

Note: One should still see a dedicated hair medical professional for a proper diagnosis and understanding of scalp issues.


There are many more different functions for botox, both aesthetic and medically! Botox to the chin area to relax a wrinkled chin which can sometimes provide a lengthened, v shaped chin effect.

Cosmetic usage of botulinum toxin is relatively safe in small doses and in the right hands. Read more of our opinion on this.

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