Botox primarily temporarily regulates signals involved in muscle movement and sweat secretion. It is not a treatment that adds volume to sagging areas like filler. You must first distinguish whether it is a change that occurs when making facial expressions, a line that remains even when you are relaxed, or a combination of volume loss or sagging skin. [S02][B10][S04]
There are natural individual differences in the shape of the face and body. Just because there is a difference doesn't mean it needs treatment. This guide is a compilation of selection criteria explained in adult treatment, and is not a self-diagnosis table that recommends procedures or determines individual suitability.
Three things to remember first
- There is a difference between reducing movement and adding volume.
- Even with the same Botox, research and precautions are different for each area.
- Functions such as facial expression, chewing, and speaking are as important as the size of the change.
01. What is the difference between Botox and fillers?
‘Botox’ is widely used in everyday life to refer to botulinum toxin treatment. In actual treatment, you must check the ingredients and approvals for each product, and you should not simply compare products as if they are the same drug even though their names are different. [S01]
| Distinguish first in consultation | starting point of explanation |
|---|---|
| Wrinkles that become more evident when you make facial expressions | Assess how much muscle movement is involved. |
| A deep line that remains even when you are still | Other causes such as skin changes and volume loss are also checked. |
| Volume loss in a specific area | Let's first look at whether the problem can be solved through movement control alone. |
| Excessive sweating that interferes with daily life | Distinguish between the symptoms and causes of hyperhidrosis. |
This table is not a table that automatically assigns treatment. Multiple causes may overlap, so examination is necessary. [B01][B10]
A great guide to read together
For hollowing and volume concerns, see the dermal filler guide. For skin texture and quality, see the skin booster and collagen booster guide. For sagging, see the lifting guide.
What does it mean to complement each other?
Botox is a movement control approach, while the HA fillers compared in this guide primarily address volume and shape. Ingredients called collagen boosters target skin tissue response depending on their ingredients, and some also overlap with the role of volume supplementation. Being able to explain different causes is different from saying that all three are necessary. [S02][F01][C08]
Some adult comparative studies targeting the mouth area and chin reported additional benefits of combining Botox and HA filler. However, there is no difference in all evaluation indicators, and there is no study that proves the effect of adding a collagen booster. [C01][C02]
It cannot be generalized that ‘if movement is reduced with Botox, the collagen booster effect will necessarily be greater or last longer.’ A distinction must be made between descriptions of mechanisms and parallel studies that directly compare the products/targets in question. Small uncontrolled studies using the three approaches together cannot demonstrate any additional benefit. [C06]
Meanwhile, even in studies that evaluated HA and collagen-stimulating ingredients together, there were cases in which the expected additional benefits were not confirmed depending on the combination, site, and time of evaluation studied. [C03][C04]
Three questions to explain together“Is movement involved?”, “Is it a change in volume or shape?”, “Is it a change in skin texture/tissue?” This question is not a self-assessment chart for assigning a procedure. One approach, follow-up, and the option of no procedure are also included in the scope of consultation.
The difference between volume and material is Overlapping roles of filler and collagen booster, the difference between ingredients is Relationship between collagen booster and botox and fillerYou can continue reading here.
02. Forehead, eye area, eyebrows — look at facial expressions together
forehead
Instead of just looking at horizontal wrinkles on the forehead, we also look at eye opening habits and eyebrow position. If you only aim to reduce wrinkles, your eyebrows may feel heavy or your expression may change. [B01][S01]
Between the eyebrows
Distinguish between the lines that stand out when making an impression and the lines that remain in everyday life. Just because there is a response to movement doesn't mean all remaining lines are gone. [B01][B02]
around the eyes
Crow’s feet that appear when smiling have been studied in clinical research. Crow’s feet, under-eye hollowness and under-eye swelling are different problems. [B02][F03]
eyebrow
It is not a treatment to fill in the eyebrows, but rather an approach to balance the surrounding facial muscles. It is not a substitute for ptosis treatment. [B01]
Questions to ask during consultation: “How can the feeling of opening the eyes or the original expression change when wrinkles are reduced?”
Link to other guides: Although it is useful to distinguish between eye movement, under-eye hollowness, and skin texture, it does not mean you should add all three treatments to the eye area. First explain the risks of edema, pigmentation, and blood vessels. Undereye filler informationCheck it out together. [F03][F01]
03. Mouth area and nose - check function even with small changes
Since the area around the mouth is related to speech and eating, asymmetry and functional discomfort must be explained together. [B01][S01]
Corners of the mouth (smile)
Distinguish between the position of the corners of the mouth and their movement when smiling. Downward pulling movements and peripheral volume loss are evaluated differently. [B01]
Explain the movement, volume, and skin texture around the mouth separately. Fillers for the lips and around the mouthIt is not connected in a way that automatically adds . The fact that there are parallel studies around the mouth doesn't mean everyone needs the same combination. [C01]
Walnut chin dimpling
Evaluating the movement of the chin skin when the tendon is stretched chin dimpling botoxno see. It is not a treatment that changes the shape or length of bones. [B01]
Studies of combination treatment for chin retrusion address a different question from assessing movement that causes chin dimpling. For the distinction between chin movement and volume, see the dermal filler guide. [C02]
Lips — lip flips are different from lip fillers
Lip flip is an approach that attempts to change the appearance of the lips by controlling the movement around the lips. A 2026 study of 17 people observed temporary changes in lip height but did not identify significant volume increases. Because it is a small study without a control group, it is difficult to determine its duration or results. [B04]
Therefore, the explanation ‘creating the same volume without filler’ is not appropriate. Lip flips are movements, lip fillers are different interventions on volume and shape.no see. [B04][F05]
Orbital muscles — Vertical fine wrinkles around the mouth
There is a difference between curled lips and fine wrinkles around the mouth. Treatment goals and speech and eating functions are evaluated together. [B01][S01]
Gums – If your gums are visible when you smile
In addition to lip movement, gum exposure is influenced by the relationship between teeth, gums, and jawbone. There is a 28-person randomized controlled trial of botulinum toxin, but it was a comparison of two active treatment groups and the results do not apply to all causes of gingival exposure. If necessary, a dental evaluation comes first. [B05]
arrow nose
Distinguish between fixed nose shape and nose tip movement when smiling. This does not mean that the movement control approach will change the shape of the nasal bones and cartilage. [B01]
nose
Check for ‘bunny lines’ that appear when you wrinkle your nose. The treatment target is not determined solely by the menu name. [B01]
To Kodungga
Distinguish between the horizontal line at the root of the nose and the interlocking line between the eyebrows. Kodeung and Kodeunggaro are not the same item. The name alone does not determine a specific muscle. [B01]
Nostril reduction — To be precise, distinguish between ‘movement’ and ‘structure’
What was observed in the botulinum toxin study was a decrease in the movement of the nostrils. This is not the same as surgery that permanently reduces the structural width of the nose. Even when looking at the name ‘Botox for nose reduction’, it is important to understand the difference in movement and structure. [B06]
04. Square jaw, temples, salivary glands - parts that look similar have different causes
square jaw botox
The appearance of the chin area is not determined by muscles alone. The examination distinguishes the development of chewing muscles, bone structure, and soft tissues.
A 180-person placebo-controlled phase 3 study of benign masseter hypertrophy reported changes in muscle thickness and other factors. However, these results are not evidence that it can change bones, solve all causes of temporomandibular joint disease or bruxism, or create permanent changes. [B03]
Things to check: Discomfort in chewing, original asymmetry, and past procedures. [B01]
temple
Temporal muscle development and volume loss are different. Temporal Botox is not a treatment for temporal volume loss. [B01][F04]
For sudden pain or changes on one side, the cause must be checked before choosing a cosmetic procedure.
salivary glands
Salivary glands are not chewing muscles; they are organs that produce saliva. We do not decide on a treatment target just because the area looks large.
There are randomized trials for chronic drooling accompanying neurological diseases, etc. however The basis for treating drooling cannot be explained by converting it to the effect of cosmetic procedure on the salivary glands in healthy people. [B13]
Dry mouth and swallowing problems should be checked. For new swelling, pain, or lumps on one side, the cause should be treated first. [S01]
05. Neck, trapezius, calves — look at function, not just shape
Neck band (vertical)
When applying strength to the neck, distinguish between vertical bands that appear and horizontal neck wrinkles. Regarding the vertical neck band, a placebo-controlled phase 3 study has been published. This does not mean that sagging skin and all horizontal lines across the neck are addressed in the same way. [B07]
Discomfort related to swallowing or throat strength is an important topic for consultation. [S01]
Neck wrinkles (horizontal)
Horizontal neck pleats are not another name for vertical neck bands. Distinguish between residual lines, skin properties, and the contribution of movement. There are also small follow-up studies looking at HA fillers, but they are not interventions like Botox. [F06]
Rather than applying one treatment to all transverse neck wrinkles, we should explain what the main cause is and the limits of the change that can be achieved.
Why read the three guides together: This is to distinguish vertical neck bands, horizontal remaining lines, and changes in skin texture and tissue. There are small uncontrolled studies evaluating the three ingredients together, but this cannot be described as a standard combination for all neck wrinkles. [C06]
Rationale and limitations of horizontal neck wrinkle filler · Limitations of parallel explanation of collagen booster
trapezius muscle
The trapezius muscle is involved in shoulder and neck movements. The 2026 study evaluated 12-week changes in 20 people divided into two active treatment groups. It is a randomized study, but not a placebo-controlled trial. This small study alone cannot confirm the long-term functional safety of repeated procedures or the effectiveness of posture and pain correction. [B08]
You should first look at your daily shoulder use and the cause of the discomfort. Individual differences in shoulder shape do not indicate the need for treatment, and the choice not to treat should be respected.
calf
A prospective randomized study on the calf muscles has been published. However, the mere existence of a study cannot guarantee the degree of individual change or the long-term safety of repeated treatment. [B09]
The calf is the part used for walking and balance. Rather than judging based on circumference alone, we first explain the evaluation of exercise/gait function and other causes. The possibility of muscle weakness is no less treated than the explanation of changes in appearance. [S01]
06. Hyperhidrosis of the armpits, hands, and feet — inconvenience in daily life is the standard
Sweating is a normal physiological function. Consultation for hyperhidrosis does not begin with eliminating normal sweating, but rather begins with determining whether sweating is interfering with daily life and whether there are other causes.
Axillary (armpit)
There is a 320-person placebo-controlled randomized trial in primary axillary hyperhidrosis. This is data showing a decrease in sweating in a group of patients that interferes with daily life, and the results do not apply equally to all types of sweating problems. [B10]
hand hyperhidrosis
There are also placebo-controlled studies on hand hyperhidrosis. Delicate work and grip strength must be considered, and the discomfort and duration are not the same as in the armpits. [B11][S01]
foot hyperhidrosis
There are clinical reports of hyperhidrosis of the hands and feet, but they involve different types of toxins and treatment conditions. We do not assume that results from underarms will translate to feet or that all products have the same effect. We will discuss your pain burden and any discomfort that may affect your ability to walk. [B12][S01]
Questions to ask at your appointment: “When did it start, is it a specific area or the whole body, does it occur during sleep, and what discomfort is the biggest in your daily life?”
The links to the filler or collagen booster pages in the hyperhidrosis guide are intended to distinguish between procedures with different characteristics. This does not mean that fillers and collagen boosters are additionally needed to treat sweating. [B10][F01]
07. Things to check in safety, permits, and consultation
Having a thesis and domestic permission are different.
Products used in the paper, products to be used domestically, and approved purposes must be confirmed. The description of the parts on this page is not a list that confirms the product's licensure or the actual scope provided by the clinic. Whether each product is approved domestically and whether it is used outside of the permitted scope must be separately confirmed and explained before treatment.
‘Special area’ is not used to mean ‘new and better treatment.’ If the evidence is limited, the limitations are also explained.
Please inform us before treatment
Information that the medical staff needs to know includes past botulinum toxin treatment history, adverse reactions, medications being taken, nerve/muscle diseases, swallowing/breathing-related problems, pregnancy/lactation, etc. Do not stop taking your medication arbitrarily. [S01][S03]
Inconveniences that may arise
Local discomfort such as bruising or pain may occur. [S02]
Temporary asymmetry, changes that make the eyelids or eyebrows feel heavy, and discomfort in muscle strength or function depending on the area are possible, and results and recovery vary from person to person. [S01]
If you have difficulty breathing or swallowing after the procedure, have trouble speaking, or have a marked decrease in muscle strength throughout your body, do not consider this to be a normal condition and seek treatment immediately at the medical institution where the procedure was performed. For urgent symptoms, call 119 or the emergency room. [S01]
By what criteria are costs checked?
It is recommended to check together the product, purpose of treatment, scope of evaluation, and whether follow-up is included. This guide does not include unconfirmed product names, prices, or events. During the consultation, you should be explained the cost, expected benefits, limitations, adverse reactions, and alternatives.
08. Frequently Asked Questions
There is no such guarantee. A small, uncontrolled study using all three approaches together did not demonstrate an extension of the duration of collagen boosting with the addition of Botox. You need a basis for directly evaluating the question for each product. [C06]
Repeat procedures are not automatically required. Decide by re-evaluating changes, functions, adverse reactions, and your own needs. The timing of repeat treatment should be discussed with your medical staff. [S02]
You can't be so sure. The medical staff must re-check the initially targeted changes, actual cause, and procedure history and progress. You cannot diagnose resistance or decide on a different product based on online information alone.
It doesn't mean the same thing. A small clinical study found changes in the visible height of the lips but no increase in volume. [B04]
The study deals with movement and is not evidence for permanent structural changes. [B06]
Even if the name of the same part is the same, muscle and volume loss are differentiated. Please check the explanation of the ‘Temple’ item above first. [F04]
You cannot judge based on this guide alone. You must compare the actual product to be used, the latest domestic approvals, and the purpose of treatment. Unconfirmed permission status is not collectively marked as ‘permitted’ or ‘not permitted’.
Things to check during treatment
Rather than asking “Which part should I do?”, it starts with “Which changes are uncomfortable, and what is the cause?”
Hear an explanation as to whether the changes you are seeing are related to muscles, skin, volume, or sweat secretion, and check the expected range and functional precautions. It is also an option to wait and not rush treatment.
Related information: dermal filler guide · lifting guide · Skin Booster/Collagen Booster Guide
Continue reading on the hospital blog
- Guide to Imported Premium 1-Person 1-Vial (50U) Customized Botox — Explains selection criteria for genuine Allergan, Xeomin, and Hi-Tox botulinum toxins and 1-person 1-vial customized planning principles.
- Bulbous Nose Spreading When Smiling: Alar Botox Effects, Limits, and Duration — Explains the anatomical action of the dilator naris and LLSAN muscles and criteria for correcting dynamic nostril flaring.
- Gummy Smile Botox Injection Sites and Side Effects Guide — Covers non-surgical reduction of excessive gingival display by modulating upper lip elevator muscles and precautions for smile symmetry.
- Jawline Unchanged After Masseter Botox? Salivary Gland Botox (Parotid & Submandibular) Effects and Dry Mouth Facts — Explains differential diagnosis between masseter hypertrophy and salivary gland enlargement and dose planning to prevent xerostomia.
- Wrinkle Botox: Can Pure Toxin Be Injected Every Two to Three Months? — Summarizes the concept of complexing-protein-free pure neurotoxin and appropriate treatment intervals to prevent resistance.
- Masseter Botox Effects and Principles Explained by a Board-Certified Dermatologist — Guides masticatory muscle thickness assessment and principles for preventing cheek hollowing and compensatory temporal hypertrophy.
This material is general medical information and is not intended to replace an individualized diagnosis and treatment plan. The availability and suitability of the procedure will be determined after examination by the medical staff.
References
Thesis is information about the research subject and the product used. It is not the same as domestic approval or the scope provided by our center.
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- [S04]American Academy of Dermatology (accessed 2026-09-23). Fillers: FAQs. View source
- [S01]U.S. National Library of Medicine/MedlinePlus (accessed 2026-09-23). OnabotulinumtoxinA Injection — Drug Information. View source
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- [F04]Montes JR, et al. (2025). Improvement in Temple Hollowing with VYC-20L Hyaluronic Acid Filler: A Multicenter Randomized Controlled Trial of Safety and Effectiveness. DOI: 10.1097/PRS.0000000000011957. View source
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- [B07]Fabi S, et al. (2025 (online 2024)). Improvement of platysma prominence with onabotulinumtoxinA: Safety and efficacy results from a randomized, double-blinded, placebo-controlled phase 3 trial. DOI: 10.1016/j.jaad.2024.10.027. View source
- [F06]Siperstein R, Nestor E, Meran S, Grunebaum L, Cotofana S. (2023). One-Year Data on the Longevity and Safety of Hyaluronic Acid Filler for Static Horizontal Neck Rhytids. DOI: 10.1097/DSS.0000000000003920. View source
- [B08]Kim TH, Kang HI, Lee SJ, Jeong WS. (2026). Efficacy and Safety of LetibotulinumtoxinA Injection for Trapezius Hypertrophy: A Prospective, Randomized, Double-Blind Trial. DOI: 10.1007/s00266-026-05802-6. View source
- [B09]Han WY, et al. (2024). The Efficacy of Botulinum Toxin A Injection for Gastrocnemius Hypertrophy: A Prospective, Randomized, Double-blinded Controlled Trial. View source
- [B11]Lowe NJ, et al. (2002). Efficacy and safety of botulinum toxin type A in the treatment of palmar hyperhidrosis: a double-blind, randomized, placebo-controlled study. DOI: 10.1046/j.1524-4725.2002.02039.x. View source
- [B12]Eilertsen T, Kvammen BØ, Grimstad Ø. (2024). Botulinum Toxin A and B for Palmoplantar Hyperhidrosis. DOI: 10.1007/s13555-024-01113-3. View source
- [S03]American Academy of Dermatology (accessed 2026-09-23). Botulinum toxin therapy: Preparation. View source
- [F01]U.S. Food and Drug Administration (accessed 2026-09-23). Dermal Fillers (Soft Tissue Fillers). View source
- [C08]Ting W, et al. (2024). Multicenter randomized trial comparing PDLLA and HA in nasolabial folds (abbreviated title). View source
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- [C03]Germani M, et al. (2025). Randomized trial comparing volume retention of HA alone and HA·CaHA combination in the temporal region (title abbreviated). DOI: 10.1093/asjof/ojaf076. View source
- [C04]Barcellos, et al. (2026). Randomized trial comparing tissue remodeling between PLLA alone and PLLA·HA combination (title abbreviated). DOI: 10.1002/pat.70688. View source