Most people associate botulinum toxin with three places: the forehead, the frown lines and the crow’s feet. Those are the areas it became famous for, and they account for the majority of first appointments. They are also a small fraction of what the treatment is actually used for across the face and neck.
Dr Rami Haidar counts eleven areas in total and names ten of them on camera, leaving the last as a question for his audience. This article works through the ten, what each is treating, and why several of them are doing something quite different from softening a line.
Dr Rami Haidar | 26th September 2025 | Excellence Medical Boutique, Dubai
Botulinum toxin does one thing: it reduces the activity of a muscle it is placed into. Everything else follows from which muscle is chosen. Where a muscle creases the skin above it, relaxing it softens a line. Where a muscle pulls a structure in a direction the patient does not want, relaxing it allows the opposing muscles to win.
That second category is what surprises people. Several of the areas below are not about lines at all. They are about changing the balance between muscles that pull against each other, which shifts the position or the shape of a feature rather than smoothing its surface.
The forehead is treated to soften the horizontal lines that appear when the brows are raised. The glabella, the area between the eyebrows, is treated for the vertical frown lines produced by the muscles that draw the brows together. The crow’s feet are the lines that fan out from the outer corners of the eyes on smiling.
These three are the classic anti-wrinkle areas and they are frequently treated together, because they interact. The muscles of the upper face pull against each other, so treating one in isolation can change how the others behave.
Bunny lines are the small diagonal creases that appear across the bridge of the nose when it wrinkles, and they often become more noticeable after the glabella has been treated, since the muscle activity redistributes.
The gummy smile is the first area on this list that is not about a line at all. Where a smile exposes more of the upper gum than a patient would like, relaxing the muscle that lifts the upper lip reduces how far it travels. Nothing is smoothed. The movement itself is moderated.
Not by the patient pointing at a line. Several of the areas above produce effects some distance from where the product is placed, and several concerns that look like one problem turn out to originate somewhere else. The muscle responsible is identified first, and the treatment follows from that.
Dr Rami Haidar is a UK-trained Oral and Maxillofacial Surgeon, so the assessment at Excellence Medical Boutique in Jumeirah, Dubai begins with how a face moves rather than with the areas a patient arrived intending to treat.
The jawline is treated to produce a more defined lower face, and Dr Rami notes that it improves the midface as well, since the structures are connected rather than independent. The chin is treated where the muscle there produces a dimpled or pebbled texture on movement.
The neck is the third in this group, and it is the area most people are unaware can be treated at all. Relaxing the muscle that runs from the chest up into the lower face reduces the downward pull on the jawline, which is the principle behind the treatment covered in his piece on the Nefertiti technique.
The lip flip uses a very small amount of product to relax the muscle around the upper lip, which allows more of the lip to roll outward and read as fuller. Dr Rami describes it as increasing the volume, and it does so without any filler being placed. It is a change in position rather than in size.
The DAO, or depressor anguli oris, is the muscle that pulls the corners of the mouth downwards. Relaxing it lifts the corners, which Dr Rami describes as changing a sad smile into a happy one, and it softens the marionette lines that run down from the mouth. It is the tenth area and arguably the most underrated.
If something about your face bothers you on movement and you are not sure whether botulinum toxin addresses it, that is exactly what an assessment is for. Dr Rami sees patients at Excellence Medical Boutique in Jumeirah, Dubai.
The consultation establishes which muscle is producing the effect you have noticed, which is frequently not the one you would have guessed, and whether treating it is appropriate in your case.
Dr Rami counts eleven areas across the face and neck. This article covers the ten he names on camera: forehead, glabella, crow’s feet, bunny lines, gummy smile, jawline, chin, neck, lip flip and the DAO.
A very small dose placed to relax the muscle around the upper lip, allowing more of the lip to roll outward so it reads as fuller. No filler is involved, and the change is in position rather than in volume.
The depressor anguli oris, the muscle that pulls the corners of the mouth downwards. Relaxing it lifts the corners and softens the marionette lines, which Dr Rami describes as turning a sad smile into a happy one.
Yes. Relaxing the muscle that lifts the upper lip reduces how far it travels on smiling, exposing less of the gum. It is not treating a line, it is moderating a movement.
Yes, and it is the area most patients are unaware of. Relaxing the muscle running from the chest into the lower face reduces the downward pull on the jawline, improving definition there.
The small diagonal creases that appear across the bridge of the nose when it wrinkles. They often become more noticeable after the glabella is treated, because muscle activity redistributes to the surrounding area.
Dr Rami notes that it does, since the structures of the lower and middle face are connected rather than independent. This is one reason areas are assessed together rather than in isolation.
No. Which areas are appropriate depends on how your face moves and what concerns you, and that is established at assessment rather than selected from a list in advance.
Located in the heart of Jumeirah, Dubai, Excellence Medical Boutique is more than a clinic, it’s a destination. A sanctuary where innovation, expertise and care come together to enhance your natural beauty and confidence. Excellence Medical Boutique is conveniently located on 197 Jumeira St, Jumeirah, Jumeirah 1, Dubai. This makes it easy for patients travelling from across Dubai to visit for consultation and treatment.
