If shoulder Botox becomes less effective over time,

one option is to reconsider the type of botulinum toxin used, not just the dosage or technique.

Different products vary in purity, manufacturing process, and protein content, which may influence long-term response.

Botulax

• Cost-effective and suitable for large areas such as the shoulders
• Commonly used for maintenance treatments
• High-dose, frequent use may theoretically increase the risk of antibody formation

Coretox

• Highly purified formulation with minimal complexing proteins
• Often chosen when reduced responsiveness is suspected
• Suitable for repeated, long-term treatments

Nabota

• High-purity, stable formulation
• Good balance of efficacy and safety
• Appropriate for regular maintenance

Our approach at AVAN TOKYO

We primarily use Botulax,

and when necessary, rotate or combine with Coretox or Nabota

to maintain consistent results over time.