Botox Lip Flip, Brow Lift, Jawline, Nose and Armpits: What the Label Covers and What Is Off-Label

Botox for armpits, brow lift, jawline, nose and lip flip: which uses have a label

Botox for armpits (sweating) and four wrinkle areas have US labels, while brow lift, jawline lift, nose and lip flip are off-label. [1][2] Off-label use means using a drug for an area or in a way the label's indications do not list. The label warns that serious adverse reactions, including severe muscle weakness, trouble swallowing and pneumonia from aspiration, some fatal, have been reported in people injected for unapproved uses. [2] It says safety and effectiveness for unapproved uses have not been established. [2]

BOTOX and BOTOX Cosmetic contain the same active ingredient in the same formulation, but their labels list different indications. [2] Armpit sweating is on the BOTOX label. [1] Wrinkles are on the BOTOX Cosmetic label. [2] The table below goes area by area. For forehead, crow's feet and frown lines, see [[botox-wrinkle-areas]].

Labels change. For the jaw muscle (masseter), the maker announced on 4 August 2026 that the US FDA had accepted an application to add that indication to BOTOX Cosmetic for review, which is not an approval. [14]

Everything here is from US labels. Check the indications registered in Thailand for each brand with the Thai FDA, and choose a licensed facility with a specialist doctor to inject. [3] For names and brands, see [[botox-botulinum-names]].

Botox for sweating armpits: how far the label goes

The US BOTOX label covers severe primary axillary hyperhidrosis that topical agents do not manage well. [1] This indication is on the BOTOX label, not the BOTOX Cosmetic label. [1][2]

The label sets clear limits. Safety and effectiveness for heavy sweating elsewhere on the body have not been established, and hand muscle weakness has been reported when the palms are injected and drooping eyelid when the face is injected. [1] People should be checked for secondary causes of heavy sweating, such as an overactive thyroid, so that only the symptom is not treated. [1] Safety has not been established under age 18. [1]

Side effects reported on the label for the armpit use are pain and bleeding at the injection site, sweating elsewhere, sore throat and flu-like symptoms. [1]

A systematic review and meta-analysis of 12 randomised trials (904 people) found that Botox cut armpit sweat more than placebo when measured by weighing the sweat, and about as much as other treatments, with fewer side effects than the other treatments. [4]

Botox units are specific to each product, and the label says they cannot be compared or converted between brands. [2] So this article gives no dose or number of injection points. The doctor sets them.

Botox brow lift: off-label, and how much lift studies report

Brow lift with Botox is not an indication on the BOTOX Cosmetic label. [2] A 2026 review lists eyebrow lift among the off-label aesthetic aims. [5]

A 2000 study of 11 women aged 30 to 60 injected the muscles that pull the brow down. The brow rose significantly both at rest and when raised, by an average of about 2 to 3 millimetres at the centre of the brow, and the authors concluded it was safe and effective for a temporary brow lift. [6]

The effect on brow position depends on which muscles are treated. A 3D imaging study found the brow dropped after injections in the forehead together with the frown area, and that the change depended on how much the forehead muscle was weakened. [7] The label reports a drooping brow in 2% of people in the forehead line trials. [2]

So ask the doctor which muscles are to be injected and what happens if the brow or eyelid droops. [2][7]

Botox jawline lift (Nefertiti lift): how it differs from the neck bands the label covers

Jawline lift with Botox is not an indication on the label, even though the BOTOX Cosmetic label has an indication for neck bands. [2] The label indication is platysma bands, the vertical cords on the neck, and the label has no jawline lift indication. [2] A 2026 review lists lower-face lifting as an off-label aim. [5]

A technique called the Nefertiti lift was proposed in 2007 to make the jawline look tighter, like a small lift (mini lift). Its author reported experience in 130 patients, with very high satisfaction and few side effects, but the abstract does not mention a comparison group. [10]

A 2022 review says the platysma is the main target for treating neck bands and lifting the lower face, and warns that without good knowledge of the muscle's anatomy and the drug's properties, the injection can cause trouble swallowing, voice problems and neck weakness. [11]

The label warns that botulinum toxin treatment can make swallowing or breathing difficult, deaths have been reported from severe swallowing difficulty, and it can last for months and need a feeding tube. [2] It can also weaken neck muscles that help with breathing. [2]

Botox for the nose and nostrils: off-label, and how strong the evidence is

Botox for the nose is not an indication on the BOTOX Cosmetic label, and the studies reviewed are about correcting minor nasal imperfections. [2][12] A 2026 review lists reducing nasal flare and sculpting the nasal tip as off-label aims. [5]

A 2024 systematic review of 23 studies found Botox had been used for a drooping nasal tip, wide nostrils, minor deformities after rhinoplasty and other uses. The authors concluded it seems safe and effective for minor nasal defects and recommended larger studies. [12]

For bunny lines (wrinkles on the bridge of the nose), a 2026 article says no discrete muscle lies under the area where these lines appear, so injecting along the line, the long-standing approach, may not fit the anatomy. [13]

So do not assume Botox can reshape the whole nose. The evidence opened here covers only minor defects. [12]

Botox lip flip: off-label, and what the research says about the upper lip

A lip flip is not on the label, and the review that gathered the studies found only 7 that met its criteria. [2][8] A lip flip is Botox injected into the muscle around the upper mouth (orbicularis oris) so the upper lip rolls outward, improving contour and fullness without adding volume. [8]

A 2025 systematic review found 48 articles and 7 that met the criteria. It reported consistent upper lip eversion, high patient satisfaction, and mild, short-lived side effects such as difficulty whistling or drinking through a straw, which resolved within weeks. [8]

Another paper describes the lip flip as one of the growing off-label uses of Botox and says little has been written about it. [9]

If you want added lip volume, a lip flip is not a volume treatment. For Botox compared with filler, see [[botox-vs-filler]].

What to ask your doctor before an off-label Botox injection

Ask whether the area has a label behind it, what kind of evidence there is, and how side effects are handled. [2] The label says safety and effectiveness for unapproved uses have not been established. [2] The Thai FDA advises asking to see the substance and whether it is licensed by the Thai FDA, and choosing a licensed facility with a specialist doctor. [3]

Questions to ask the doctor:

• Does this product's label cover the area to be injected, and if it is off-label, what is the reason? [2]
• What kind of study backs this area, how big is it, and was there a comparison group? [5][10]
• Which brand is to be used, and can I see its registration number licensed by the Thai FDA? [3]
• What are the side effects for this area, such as drooping brow or eyelid, trouble swallowing or a lip that works poorly, and how would they be handled? [2][7][8][11]
• Do I have a medical condition or take medicine that makes this area unsuitable? [2]
• Who do I contact at once if I have trouble swallowing, breathing or speaking after the injection? [2]