Extra Facial Aesthetic Indications of Botulinum Toxin: A Review

The document reviews the use of botulinum toxin (BTX) for aesthetic purposes beyond facial applications, including neck rejuvenation, shoulder slimming, calf and ankle slimming, and androgenetic alopecia. BTX is injected into the platysma muscle for neck rejuvenation, the scalp for androgenetic alopecia, the gastrocnemius and soleus muscles for calf and ankle slimming, and the trapezius muscle for shoulder slimming. For shoulder slimming, 5-10 units of BTX A are injected at five to six points on each side of the trapezius muscle, totaling 30-50 units. Complications can include neck muscle weakness and difficulty in shoulder joint extension. Regular injection can lead to neurogenic atrophy with muscle mass loss. The authors recommend marking the bulkiest portion of the trapezius from the frontal view and the injection points from the posterior view, while avoiding the descending margin of the trapezius.