If you have:

• Had shoulder Botox but saw little improvement

• Undergone arm liposuction but still feel your neck/shoulder area looks bulky

• Strong upward shoulder protrusion

The cause may not be fat or trapezius muscle — it may be the superior angle of the scapula (shoulder blade).

This is especially common in:

• Slim patients

• People with desk jobs

• Those with chronic poor posture

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Why Shoulder Botox Sometimes Doesn’t Work

Standard shoulder Botox targets the trapezius muscle.

It works well when trapezius hypertrophy is the main cause.

However, if:

• The scapula itself is elevated

• The deeper levator scapulae muscle is overactive

Then trapezius Botox alone may not be enough.

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The Key: Levator Scapulae

The levator scapulae muscle lifts the shoulder blade upward.

When overactive, it causes:

• A shorter-looking neck

• A bulky upper shoulder contour

• Less elegant dress/shoulder lines

At AVAN TOKYO, we use ultrasound guidance to precisely inject Botox into the levator scapulae when indicated.

This allows us to:

• Reduce upward shoulder protrusion

• Create a longer neck appearance

• Refine the upper body silhouette

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Horizontal vs. Vertical Shoulder Fullness

To sculpt elegant shoulders:

• Lateral fullness → Arm/shoulder liposuction

• Upward fullness → Levator scapulae Botox

A proper anatomical evaluation is essential.

Not all shoulder bulges are caused by fat.

At AVAN TOKYO Ginza Liposuction Clinic, we design treatments based on anatomy, not assumptions.

Our goal is a refined upper body that enhances your natural silhouette.