Botulinum Toxin Injection
Expression lines on the forehead, between the eyebrows, at the corners of the eyes, masseter prominence, clenching, sweat under the armpits, etc. We assess facial movement, muscle strength, and asymmetry, then tailor the injection sites and dose to the treatment goal.
Not only the Dose of effect,Facial expressions you want to keep and changes you want to avoidwill also be shared to assemble the treatment.
Are you worried about wrinkles when you make facial expressions, strong muscle movements, or sweat?
Concerned about facial expression lines on the forehead, between the eyebrows, and at the corners of the eyes?
Lines at the bridge of the nose or bunny lines are becoming noticeable.
Downturned mouth corners or chin dimpling are a concern.
My gums show prominently when I smile.
Jaw tension or clenching has made the masseter muscles prominent.
Underarm sweating or visible sweat marks are affecting daily life.
Package labeling: BOTOX VISTA, botulinum toxin type A injection, purified neurotoxin complex, 50 units, Allergan. The Japanese lines repeat “Botox Vista” and “50 units.”
Wrinkles that appear when you make facial expressions are related to muscle movement, but other methods such as hyaluronic acid injections or device treatments may be suitable for deep grooves or lack of volume that remain even when you do not express your face.
This is a treatment in which a botulinum toxin preparation is injected into the muscles to temporarily suppress the signals transmitted from the nerves to the muscles. By adjusting excessive muscle movement, it is used to treat facial wrinkles and tension in the masseter prominence. It may also be used to suppress nerve transmission to the sweat glands that secrete sweat.
Generally, changes will appear a few days after injection, and the condition will be evaluated in about 2 weeks. The duration is approximately 3 to 4 months, but it varies depending on the treatment area, preparation, dosage, and constitution.
Illustrated treatment areas: forehead (horizontal forehead lines); crow’s feet; glabella (vertical frown lines); bunny lines (horizontal lines at the nasal root); downturned corners of the mouth; gummy smile (gum show when smiling); masseter area (clenching and jaw fullness); chin (pebbled “orange-peel” lines); and platysma (vertical neck bands).
The purpose and injection design are different for facial wrinkles, contours/muscles, and sweat problems.
Three treatment groups. Expression lines: forehead, glabella, crow’s feet, and bunny lines—areas where repeated facial movement makes lines prominent. Facial contour and mouth area: masseter, gummy smile, corners of the mouth, chin, and platysma—used to address clenching, the appearance of the mouth area, and neck tension. Sweating concerns: underarms, palms, and forehead—botulinum toxin is also used for troublesome sweating in these areas.
Forehead, between the eyebrows, the corners of the eyes, the root of the nose, bunny lines, chin, corners of the mouth, gummy smile, etc. Create facial expressions and check muscle movements and left-right differences.
We assess the size and movement of the masseter and neck muscles, then determine candidacy according to facial contour and muscle tension. If the main cause is bone structure or fat, we will recommend a different treatment.
If armpit sweat becomes a burden to your daily life, this treatment is used to suppress sweating. We will check your symptoms and medical history and discuss other treatment options.
*BOTOX VISTA is approved in Japan for expression lines between the eyebrows and the corners of the eyes in adults under 65 years of age. Other parts/purposes include off-label uses.
We assess the relevant muscles both at rest and during movements such as raising the eyebrows, frowning, smiling, and clenching the jaw.
We will ask you about the area you want to make wrinkles less noticeable and the expression you want to leave. The dose is balanced by area to reduce the risk of excessive weakness, heaviness, or an unnatural result.
The final effect and any asymmetry cannot be assessed immediately after injection. We will check the situation based on the time when the changes stabilize and determine the necessary response.
Planning considers which muscles to treat, the precise injection points, and the appropriate dose.
We do not just aim for a strong effect, but consider the dosage according to the desired change and the facial expression you want to maintain.
Check the movement when making facial expressions to determine the muscles related to the problem and the injection location.
We will check muscle strength, facial expressions, left-right differences, eyebrow and eyelid Injection sites, bone structure, and past treatment history.
Left comparison: excessive effect can make facial expression feel heavy, lower the brows, and make smiling difficult. Right sequence for a natural result: identify the muscles that need treatment → adjust to the necessary dose → preserve natural expression. Assessment checks five factors: muscle strength, habitual expression patterns, left-right asymmetry, eyelid condition, and skeletal structure.
An excessive dose may restrict facial movement or cause brow or eyelid heaviness and asymmetry. We use a conservative initial dose and incorporate the two-week response and previous treatment results into future planning.
If the clinical review shows an insufficient effect, an additional dose may be placed in the necessary areas. The doctor will decide the area, Dose, and whether or not to add it.
After reviewing your goals, treatment history, and preferences, the physician will recommend an appropriate product.
AbbVie's Allergan series botulinum toxin type A preparation. In Japan, it has been approved for the treatment of facial wrinkles between the eyebrows and the corners of the eyes in adults under 65 years of age. It is a domestically approved product, and clinical trial data regarding long-term repeated administration has also been published. Before treatment, the physician reviews candidacy, safety considerations, and potential adverse effects.
Package labeling: BOTOX VISTA, botulinum toxin type A injection, purified neurotoxin complex, 50 units, Allergan. The Japanese lines repeat “Botox Vista” and “50 units.”
This is a botulinum toxin type A preparation developed by the Korean biopharmaceutical company Medytox. Medytox's main products are botulinum toxin preparations and hyaluronic acid fillers, and its Japanese subsidiary is Mdity International Co., Ltd. This product does not contain complex proteins, and is selected by your doctor based on your treatment history and concerns about resistance. Effects and duration vary from person to person. Since it is unapproved in Japan, we will explain the acquisition route and approval status during your consultation.
Please check the latest electronic package insert for the scope of domestic approval, usage/dose, side effects, etc. before treatment.
In addition to facial features, the injection point is determined by checking the movement of the muscles when making facial expressions, the Injection site of the eyebrows and eyelids, and the difference between the left and right sides.
To avoid an overtreated result, the image contrasts heavy expression, lowered brows, and difficulty smiling with the clinic’s approach: identify the muscles that require treatment, use only the necessary dose, and preserve natural expression. Examination evaluates muscle strength, habitual expression patterns, left-right asymmetry, eyelid condition, and skeletal structure.
We do not aim only to have a strong effect, but to share the changes we want and the changes we want to avoid. Previous treatment results are also considered when planning the dose.
Four-step dose and follow-up sequence: 1) adjust the initial dose while observing natural expression; the clinic does not start with a large dose. 2) Confirm at about two weeks; botulinum toxin begins working over several days and generally stabilizes at about two weeks. 3) If the effect is weak, a complimentary touch-up may be performed at the two-week review. 4) Use the previous response to guide later dosing rather than changing the injection pattern without reference to the prior result. Caution: an excessive dose cannot be reduced afterward, while an insufficient effect can be adjusted with an additional dose.
The condition will be evaluated approximately two weeks later, and the effectiveness and duration will be reflected in the next treatment design. If you have any symptoms that concern you, please contact us as soon as possible.
Clinic flow, left to right: consultation—confirm concerns and preferences; expression check—assess muscle movement and left-right asymmetry; injection—carefully inject the required areas; two-week review—confirm that the effect looks natural.
We will introduce cases of Botox alone and cases that combined hyaluronic acid and device treatment.
Scroll horizontally to see 9 cases
Case title: “A smaller-looking face with hyaluronic acid.” Photographs are ordered Before → After. Clinic credit: Minato Motomachi Beauty and Plastic Surgery Clinic / NIE CLINIC.
This is a complex treatment that considers muscle movement and volume deficiency separately.
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Treatment sequence shown: Before treatment; botulinum toxin injections to the forehead and glabella; ptosis surgery; under-eye surgery with fat removal; and Juvéderm Voluma hyaluronic acid filler, 6 cc.
Let's look back at the roles and changes of multiple treatments including Botox.
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Clinical comparison ordered Before → After. Clinic credit: Minato Motomachi Beauty and Plastic Surgery Clinic / NIE CLINIC.
This is a case in which contour support and facial muscle movement were adjusted using separate treatments.
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This is a case where the outline of the muscles and the shape of the forehead are considered together.
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This is a complex case that combines different treatments for the skin, fat, and masseter muscles.
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Consider volume correction in combination with muscle movement.
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This is a case in which multiple facial muscles were identified and injections were performed in each location.
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This is a case where muscle, volume, and excess skin are considered separately.
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This is a case that combines masseter muscle movement and contour support.
Read the case column*Case photos do not guarantee treatment results. There are individual differences in the Dose required, progress, and results.
BOTOX VISTA® and CORETOX® currently have the same pricing.
*The displayed price includes tax. This treatment is not covered by Japan's public health insurance. The indication, formulation, injection site, and dosage are determined by examination.
We will confirm your concerns, treatment history, past medical history, medications, and desired changes to determine whether Botox injections are appropriate.
We check facial expressions, clenching, and other movements depending on the treatment area, and plan the injection location and Dose.
If necessary, cool and inject in multiple locations with a thin needle. Treatment time varies depending on the area.
We will explain how to spend the day and the symptoms to be aware of. Do not press or rub the injection site firmly.
Check the effectiveness and left/right differences. If we determine that the effect is weak during the examination, we will make additional adjustments to the necessary areas free of charge.
This is not a treatment that is completed immediately after injection. Changes will appear over a few days, and the condition will be evaluated approximately two weeks later.
Effect timeline: 1) same day—immediately after injection, the result is not yet complete; 2) two to three days—the effect begins gradually; 3) one to two weeks—the effect stabilizes and is easier to assess; 4) three to four months—a general guide to duration. Clinic flow: consultation to confirm concerns and preferences → expression check for muscle movement and asymmetry → careful injection into required areas → review at two weeks to assess a natural effect.
Immediately after injection is not the time to judge the final result.
Changes will gradually begin to appear in the treated area.
We will check the effect and the difference between the left and right sides, and if it is weak, we will add it for free at the doctor's discretion.
This is a general guideline for duration. It varies depending on the site and dosage.
*The appearance and duration of effects vary from person to person. If you have any symptoms or progress that are of concern, please consult us as soon as possible.
Pain at the injection site, redness, swelling, bruising, headache, discomfort, differences between left and right sides, insufficient or excessive efficacy, etc. may occur.
Drooping of the eyelids and eyebrows, difficulty in moving facial expressions, differences between the left and right corners of the mouth, reduced chewing strength, and difficulty in tightening the neck may occur.
On the day of injection, please do not rub the injection site strongly, and refrain from strenuous exercise, drinking alcohol, and prolonged hot baths or saunas. You can wash your face and apply makeup only after the bleeding has stopped.
If you have difficulty breathing, difficulty swallowing, severe muscle weakness throughout the body, or severe allergic symptoms, please contact a medical institution immediately.
BOTOX VISTA® is approved in Japan for the treatment of expression lines between the eyebrows and the corners of the eyes in adults under 65 years of age. Other parts/purposes include off-label uses. CORETOX® is a drug that has not been approved in Japan, and is a preparation that must be obtained through legal import procedures under the responsibility of the doctor. There may be cases where there are no approved products with the same ingredients and performance in Japan. We will explain the approval status in other countries, the possibility of being excluded from the Japan's Relief System for Sufferers from Adverse Drug Reactions, costs and risks at the time of your consultation.
View PMDA drug information for patientsDepending on the injection site and Dose, it may be difficult to move your facial expressions or there may be differences between the left and right sides. At our clinic, we will check your facial expressions and muscle movements to determine the area and Dose needed. There are individual differences in the finish.
Generally, changes will appear after a few days, and the condition will be evaluated in about two weeks. The duration of effect is approximately 3 to 4 months, but this will vary depending on the area, preparation, dosage, and constitution.
A thin needle is used, but the injection is painful. Cooling is applied as necessary, and treatment is performed with consideration given to pain and bruising. There are individual differences in how it feels.
If the bleeding at the injection site has stopped, you can wash your face and apply makeup on the same day. Do not press or rub the injection site firmly.
If you are pregnant or breastfeeding, have a neuromuscular disease, or have a history of allergies to drugs used, you may not be able to receive treatment. Be sure to tell your doctor about your medication and medical history.
Botox injections mainly adjust muscle movement, and hyaluronic acid injections are a treatment that supplements volume and contour. Treatment for the same wrinkle varies depending on the cause, so a diagnosis is made through a medical examination.
If you are worried that the treatment will be too effective or don't know which area to choose, please let us know the expression you want to maintain and your previous treatment history. We will recommend whether Botox is suitable for you, including whether you should prioritize another treatment.
