Most patients think of Botox as a wrinkle treatment, and at Southwest Plastic Surgery it is one of the most popular treatments at the Med Spa. But Dr. Frank Agullo will tell you the molecule does far more than that. As he explains it, botulinum toxin in essence inhibits the release of acetylcholine, the chemical signal that nerves send to the tissue on the other side. In the traditional use for wrinkles, the nerves are sending acetylcholine to the muscles to contract and create a wrinkle, and the toxin prevents that release. In the same fashion, it can work on other targets, like sweat glands.

That single mechanism opens up a long list of treatments the practice offers. Here is the full range.

Excessive Sweating

Botulinum toxin can be used for excessive sweating, in medical terms hyperhidrosis. The FDA has actually approved it for excessive underarm sweating. The toxin is injected into the skin every half an inch to cover the area of the sweat glands, and a single underarm treatment usually lasts anywhere between four to six months and has to be repeated.

Off-label, the practice uses it the same way for sweaty palms, the soles of the feet, a sweaty scalp, and even the forehead. It doesn’t change how much you sweat in untreated areas, but it is very effective. Dr. Agullo has had patients whose excessive sweating was disabling, and for them these treatments are life-changing. As a bonus, treating the sweat glands also decreases body odor production, since the smell comes from the same glands.

Chronic Migraine and Headaches

The FDA has approved botulinum toxin for chronic migraines and headaches for more than fifteen years now. There is a very specific protocol, about thirty injection points in the forehead, scalp, and neck. It is a preventative treatment, meaning it prevents the onset of new headaches rather than curing an active one. Dr. Agullo notes that many patients who get toxin purely for cosmetic reasons tell him they have had fewer headaches since they started.

Jaw Clenching and a Slimmer Jawline

Botulinum toxin is used for jaw clenching and teeth grinding, injected into the masseter muscle to decrease the strength of the bite. As a side effect, it can slim a heavy jawline by decreasing the size of the masseter, creating the shadow effect a lot of patients aspire to. It also softens spasms and nervous tics around the eyes, helps create symmetry in patients with facial nerve palsy, and can be used for neck muscle spasms.

The Less Traditional Treatments

TrapTox is injected into the trapezius muscle, sometimes called the Barbie. It reduces the mass of the trapezius, which creates a more slender and longer neck, and some patients use it for comfort because they carry significant stress in their shoulders. The practice also uses toxin around the mouth to correct gummy smiles by relaxing the muscles that elevate the upper lip, and to smooth a pebbly or orange peel chin by relaxing the mentalis muscle.

The Skin-Quality Bonus

There are applications where the team does microdroplets of botulinum toxin over the skin. These very superficial injections decrease oil production and smooth out the skin over time. Dr. Agullo noticed it in patients treated for frown lines, that the area where the Botox is injected improves in skin quality and looks younger over time. It is also used off-label for rosacea flushing, and it pairs well with microneedling for overall skin quality.

About Dr. Frank Agullo

Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and completed a plastic surgery fellowship at the Mayo Clinic. He is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine and has been named a Castle Connolly Top Doctor for thirteen consecutive years.

Ready to Talk?

Whether you are interested in the cosmetic uses or one of the medical and functional ones, the team at Southwest Plastic Surgery can walk you through what botulinum toxin can and cannot do for your specific concern.

For the surgeon’s editorial tour from the established to the experimental, see Dr. Agullo’s essay on drworldwide.com. For the clinical patient guide, see the companion post on agulloplasticsurgery.com.

Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.

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