Botox is one of the most requested aesthetic treatments in Tokyo — from expression lines around the eyes and forehead to jawline slimming, shoulder tension, and hyperhidrosis. This guide explains what botulinum toxin type A does, which brands are used in Japan, treatable areas with real pricing in yen, aftercare, and how our English-speaking team at BIOTOPE CLINIC (Shirokanedai, Minato-ku) supports international patients.
What you’ll learn in this article:
- How botulinum toxin actually works on facial and body muscles
- Every treatable area with full pricing in yen — both Allergan Vista and Korean botulinum toxin
- How to choose between Allergan and Korean brands (side-by-side comparison)
- Downtime, effect duration, side effects, and contraindications
- Where and how to book an English consultation in Tokyo
Have a question about this treatment?
Message us on LINE or WhatsApp — our English-speaking team usually replies the same day.
What Is Botox?
Botox is the trade name for botulinum toxin type A, a purified protein produced by Clostridium botulinum. When injected in tiny, controlled doses into a specific muscle, it blocks the release of acetylcholine — the chemical messenger that tells the muscle to contract. The muscle relaxes without being paralysed elsewhere in the body.
In cosmetic use, this produces two distinct effects. Injected into small mimetic muscles of the face (frontalis, corrugator, orbicularis oculi), it softens the dynamic wrinkles caused by facial expression. Injected into larger muscles such as the masseter (jaw) or trapezius (shoulder), it reduces bulk over time as the muscle is used less, creating a slimmer contour.
Botox has been used cosmetically worldwide for more than three decades since FDA approval for glabellar lines in 2002, and for medical use since 1989. Millions of treatments are performed each year internationally.
Botox Brands We Use
We offer two options and select together with you at consultation. The choice comes down to regulatory approval, price, and personal preference.
Allergan Botox Vista (Japanese-approved)
Manufactured by AbbVie/Allergan and formally approved by Japan’s Ministry of Health, Labour and Welfare (PMDA). This is the formulation with the longest global safety record and the strongest evidence base. Preferred by patients who prioritise regulatory status and long clinical history.
Korean botulinum toxin (KFDA-approved)
Brands such as Nabota, approved by the Korean Ministry of Food and Drug Safety but not domestically approved in Japan. Clinical performance is broadly comparable in reports to date, and pricing is more accessible. Informed consent regarding the unapproved status in Japan is required before treatment.
Both brands are used widely in Tokyo. Most first-time patients trying a small area (e.g. crow’s feet) start with the Korean brand; patients treating larger areas or with a strong preference for domestically approved products choose Allergan Vista.
Dr. Karibe’s Note
A common question from our international patients at BIOTOPE CLINIC is whether Korean botulinum toxin is “less effective” than Allergan.
In our clinical experience across both formulations, well-injected Korean toxin gives comparable early results — the meaningful differences are regulatory approval, longevity data over multi-year use, and the confidence some patients simply feel with the globally established brand.
If you are treating a small area for the first time, either is a reasonable choice. If you are committing to regular multi-area maintenance for years, we usually recommend discussing Allergan Vista at consultation.
Treatable Areas
Botox has a wide range of aesthetic and functional uses:
- Upper face wrinkles: frown lines (glabella), forehead lines, crow’s feet, bunny lines on the nose
- Lower face: chin dimpling, gummy smile, downturned mouth corners
- Facial contouring: masseter reduction for a softer jawline, Nefertiti lift for jawline definition
- Hyperhidrosis: underarms, palms, and soles
- Body: trapezius (shoulder) tension, calf slimming
- Other: bruxism (teeth grinding), salivary gland (submandibular saliva reduction), scalp (headache/sweating)
Some indications are cosmetic; others (severe hyperhidrosis, chronic migraine, bruxism) have functional benefit. Suitability is confirmed at consultation.
Treatment Flow
A typical visit takes 20–40 minutes from arrival to departure.
- Consultation. The physician assesses your muscle strength, facial balance, and treatment goals. Photos are taken for records.
- Cleansing and marking. The treatment area is cleansed; injection points are mapped based on your muscle movement.
- Topical anaesthesia (optional). A numbing cream can be applied for sensitive areas such as the palms, soles, or forehead. Adds around 15 minutes.
- Injection. A very fine needle is used. Most facial treatments take under 10 minutes; body treatments (calves, shoulders) may take 15–20 minutes.
- Cooling. The treated area is cooled briefly to minimise swelling and bruising.
- Home. You may return to normal activities immediately. Makeup is permitted the same day.
Cost in Tokyo
All prices below are tax included. Two brand tiers are offered so you can weigh regulatory status and price at consultation.
Facial Areas — Expression Lines and Contouring
| Area | Allergan Vista | Korean brand |
|---|---|---|
| Forehead | ¥22,000 | ¥9,900 |
| Glabella (frown lines) | ¥22,000 | ¥9,900 |
| Crow’s feet | ¥22,000 | ¥9,900 |
| Bunny lines (nasal bridge) | ¥22,000 | ¥9,900 |
| Nostril flare | ¥22,000 | ¥9,900 |
| Chin | ¥22,000 | ¥9,900 |
| Gummy smile | ¥22,000 | ¥9,900 |
| Mouth corner lift | ¥22,000 | ¥9,900 |
| Botox lift | ¥55,000 | ¥45,000 |
| Nefertiti lift | ¥55,000 | ¥45,000 |
| Micro-botox | ¥33,000 | ¥22,000 |
Masseter / Jaw Slimming
| Area | Allergan Vista | Korean brand |
|---|---|---|
| Masseter — 60U | ¥35,000 | ¥29,800 |
| Masseter — 100U | ¥68,000 | ¥45,000 |
Hyperhidrosis and Body
| Area | Allergan Vista | Korean brand |
|---|---|---|
| Both underarms — 60U | ¥35,000 | ¥29,800 |
| Both underarms — 100U | ¥68,000 | ¥45,000 |
| Both calves — 60U | ¥35,000 | ¥29,800 |
| Both calves — 100U | ¥68,000 | ¥45,000 |
| Palms | ¥55,000 | ¥45,000 |
| Soles | ¥55,000 | ¥45,000 |
| Trapezius / shoulder — 100U | ¥75,000 | ¥55,000 |
| Trapezius / shoulder — 200U | ¥148,000 | ¥98,000 |
| Head (20U) | ¥35,000 | ¥22,000 |
| Salivary gland | ¥32,000 | ¥35,000 |
Options
- Topical anaesthesia: ¥2,200
- Physician surcharge (select procedures): ¥11,000
For an accurate quote — especially if you are combining multiple areas — we recommend booking a consultation.
Allergan Vista vs Korean Botox: Which Should You Choose?
The two brand tiers use the same active molecule (botulinum toxin type A) and produce broadly similar early results in the hands of an experienced injector. The meaningful differences are regulatory approval, evidence base, price, and — for some patients — brand confidence.
| Factor | Allergan Vista | Korean botulinum toxin |
|---|---|---|
| Manufacturer | AbbVie / Allergan (USA) | Korean pharmaceutical makers (e.g. Nabota) |
| Regulatory approval in Japan | PMDA-approved (Ministry of Health, Labour and Welfare) | Not domestically approved (KFDA-approved in Korea) |
| Global clinical history | Longest — used cosmetically since the 1990s, FDA-approved for glabellar lines in 2002 | Approved KFDA 2014; several years of published data |
| Onset of effect | 2–3 days, full at 1–2 weeks | 2–3 days, full at 1–2 weeks |
| Typical duration | 3–6 months | 3–6 months |
| Price (single facial area) | ¥22,000 | ¥9,900 |
| Price (masseter 100U) | ¥68,000 | ¥45,000 |
| Best for | Patients who prioritise the longest safety record, formal Japanese approval, or long-term multi-area maintenance | Patients trying botox for the first time, treating a single small area, or prioritising accessible pricing |
How most patients choose in practice. First-time patients trying a small area (crow’s feet, glabella) commonly start with the Korean brand — the cost of “trying it” is low and results are visible within two weeks. Patients committing to regular multi-area maintenance over several years, treating larger doses (masseter 100U, shoulders 200U), or with a strong personal preference for domestically approved products, generally choose Allergan Vista. Combining brands across visits is also possible — some patients use Korean toxin for facial expression areas and Allergan for larger body treatments.
Important: Neither brand is a shortcut for injection skill. The single biggest determinant of a natural, symmetric result is the physician’s dosing and placement, not the brand.
Have a question about this treatment?
Message us on LINE or WhatsApp — our English-speaking team usually replies the same day.
Effect and Duration
Results begin to appear 2–3 days after injection and become fully visible in 1–2 weeks. Effects typically last 3–6 months before gradually fading as the treated nerve endings recover. Repeat treatment maintains results; over time, some patients find they can extend the interval between sessions as the treated muscle progressively weakens with use.
Aftercare
- Makeup is permitted on the day of treatment.
- Do not rub or massage the treated area for 24 hours (this may cause the toxin to migrate).
- Avoid sauna, hot bath, intense exercise, and alcohol on the day of treatment.
- Sleep face-up on the first night when possible.
- A follow-up review at 2 weeks is recommended for first-time treatments to check symmetry and dose.
Side Effects and Risks
Botox is a well-tolerated treatment when performed by an experienced injector, but no injection is entirely risk-free. Possible reactions include:
- Redness, mild swelling, or bruising at the injection site (usually resolves within a few days)
- Transient headache in the first 24–48 hours
- Temporary asymmetry or heaviness of the eyelid or brow (typically resolves as effect softens)
- Mild flu-like symptoms rarely reported after larger doses
- Allergic reaction (uncommon)
Serious complications such as ptosis (drooping eyelid) are rare and typically resolve within a few weeks. Choosing an experienced injector and following aftercare instructions substantially reduces these risks.
Common Misconceptions
“Botox will make my face look frozen.” This impression comes from over-dosing seen in early aesthetic media. Modern practice uses lower, targeted doses to preserve natural expression — the aim is a rested, softened look, not a rigid one.
“Once I start, I have to keep doing it forever.” The effect simply wears off over 3–6 months and the muscle returns to its baseline. There is no “rebound” that makes wrinkles worse than before.
Contraindications
Botox is not offered to:
- Patients who are pregnant, planning pregnancy, or breastfeeding
- Patients with a history of botulism or neuromuscular disease (e.g. myasthenia gravis, Lambert-Eaton syndrome)
- Minors under 20
- Patients currently taking certain aminoglycoside antibiotics or muscle relaxants that can potentiate the effect
Please disclose all medications and medical history at consultation.
Where to Book in Tokyo
Within our clinic group, English-speaking consultations are handled at BIOTOPE CLINIC in Shirokanedai (Minato-ku, Tokyo) by Dr. Jun Karibe, a board-certified plastic surgeon. Our sister clinic Kojimachi Dermatology & Plastic Surgery Clinic in Ichigaya (Chiyoda-ku) handles Japanese-language insurance dermatology. Bookings and enquiries in English are easiest via LINE or WhatsApp — our team typically replies the same day.
Frequently Asked Questions
- Q. Does it hurt?
- Discomfort is minimal — most patients describe it as a small pinch. Topical anaesthesia (¥2,200) is available for sensitive areas such as the palms, soles, or forehead.
- Q. When can I return to work?
- Immediately. There is no downtime. Occasional pinpoint redness or mild swelling can be covered with makeup.
- Q. How often should I repeat treatment?
- Most patients maintain results with treatment every 3–6 months. Masseter and calf treatments can often be repeated less frequently once the muscle has slimmed.
- Q. Can I have Botox before an important event?
- We recommend scheduling at least 2 weeks before the event so the effect is fully visible and any minor asymmetry can be reviewed.
- Q. Is English available at consultation?
- Yes — English-speaking consultation is available at BIOTOPE CLINIC in Shirokanedai. Contact us via LINE or WhatsApp to arrange.
- Q. Can I combine Botox with fillers or laser on the same day?
- In most cases yes. Botox is often combined with hyaluronic acid filler for static wrinkles that remain after muscle relaxation. Combination plans are discussed at consultation.
Have a question about this treatment?
Message us on LINE or WhatsApp — our English-speaking team usually replies the same day.
Summary
Botox is a well-established, non-surgical treatment for expression wrinkles, jawline and calf slimming, hyperhidrosis, and shoulder tension. In Tokyo, two brand tiers are widely used: Japanese-approved Allergan Vista and KFDA-approved Korean botulinum toxin, with facial areas starting from ¥9,900. Results appear over 1–2 weeks, last 3–6 months, and require no downtime. English-speaking consultations for international patients are handled at BIOTOPE CLINIC in Shirokanedai — please reach out via LINE or WhatsApp with any questions.
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Book a Consultation or Treatment
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References
- Carruthers A, Carruthers J. Botulinum toxin type A: history and current cosmetic use in the upper face. Seminars in Cutaneous Medicine and Surgery. 2001.
- Small R. Botulinum toxin injection for facial wrinkles. American Family Physician. 2014.
- Naumann M, Lowe NJ. Botulinum toxin type A in treatment of bilateral primary axillary hyperhidrosis: randomised, parallel group, double blind, placebo controlled trial. BMJ. 2001.
- Nigam PK, Nigam A. Botulinum toxin. Indian Journal of Dermatology. 2010.
- U.S. Food and Drug Administration. Botulinum Toxin Products Information. https://www.fda.gov/
SUPERVISED BY
Dr. Jun Karibe
MD
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