Botox (Botulinum Toxin Type A)
Korean: 보톡스 (Botokseu) · Full term: 보툴리눔 독소 주사 · Category: Injectables · Last reviewed: 2026-05-01
A purified bacterial neurotoxin injected in small doses into facial muscles to temporarily relax them and reduce the appearance of dynamic wrinkles. Korea has the world's most competitive domestic portfolio of approved BTX-A biosimilar products.
What it is
Botulinum toxin type A (BTX-A) is a purified protein complex produced by Clostridium botulinum. It is supplied as a lyophilized powder, reconstituted with saline, and injected in minute doses directly into target muscles. Korean injectors and clients colloquially refer to all brands as "보톡스" (Botox) regardless of manufacturer.
In Korea, BTX-A is the most common non-surgical aesthetic procedure. Common indications go beyond classic glabellar and forehead wrinkle reduction to include masseter reduction for facial slimming, hyperhidrosis, micro-botox skincare protocols, and platysma band treatment. The Korean market includes at least 14 distinct domestic BTX-A brands as of 2026. The dominant producers are Medytox (Meditoxin, Innotox, Coretox), Daewoong Pharmaceutical (Nabota), and Hugel (Botulax).
How it works
BTX-A binds to the presynaptic membrane of cholinergic nerve terminals at the neuromuscular junction. After receptor-mediated endocytosis, the toxin's light chain cleaves SNAP-25, a component of the SNARE protein complex required for acetylcholine vesicle fusion. This prevents neurotransmitter release and produces selective, reversible chemodenervation of the target muscle.
Formulations differ in their complexing protein profiles. Standard products (onabotulinumtoxinA, abobotulinumtoxinA) carry 900-kDa complexing proteins. IncobotulinumtoxinA (Xeomin) and Medytox's Coretox are 150-kDa "naked" toxin preparations marketed as having reduced immunogenicity.
Origin and development
Allergan commercialized onabotulinumtoxinA (BOTOX) for therapeutic use in 1989 and received FDA cosmetic approval for glabellar lines in 2002. Korea entered the global market when Medytox commercialized Meditoxin, the country's first domestically produced BTX-A, making Korea the third country after the US and UK to produce botulinum toxin commercially.
Daewoong Pharmaceutical's Nabota received MFDS approval in 2014 and FDA approval in February 2019 as prabotulinumtoxinA-xvfs (Jeuveau, BLA 761085). Hugel's Botulax received US FDA approval as Letybo on February 29, 2024. Korean price transparency, accelerated by 강남언니 platform listings from 2015 onward, drove domestic prices for standard areas down from roughly ₩200,000 to as low as ₩20,000.
In a notable regulatory event, MFDS revoked manufacturing and sales licenses for Meditoxin 50U, 100U, and 150U effective June 25, 2020, after finding evidence of an unapproved raw material and fabricated efficacy and safety data. The 200U formulation was not revoked.
Regulatory status
| Jurisdiction | Status | Notes |
|---|---|---|
| Korea (MFDS) | Multiple brands approved | Pharmaceutical drug (의약품). Meditoxin 50U/100U/150U revoked June 25, 2020 |
| United States (FDA) | Multiple brands approved | Botox (cosmetic, 2002); Jeuveau (2019); Letybo (2024). Korean brands Meditoxin, Innotox, Coretox, and Neuronox are NOT FDA-approved |
| European Union (CE) | Multiple brands approved | Allergan Botox EMA-approved; Nabota EMA-approved as Newtox; Botulax CE-marked |
Typical protocol
- Common doses: glabellar lines 10 to 20 units; masseter reduction 25 to 50 units per side; forehead 10 to 20 units
- Reconstitution: 2.5 mL saline per 100-unit vial is a typical standard
- Onset: 2 to 10 days
- Duration: 3 to 6 months
- Anesthesia: most sessions performed without anesthesia; topical numbing cream is occasional
- Downtime: minimal. Avoid lying down for 4 hours and vigorous exercise for 24 hours after injection
- Re-treatment: every 3 to 6 months
Commonly reported effects
Published data confirms significant reductions in dynamic wrinkle depth across glabellar, forehead, and periorbital regions. Ptosis (eyelid drooping) is the most clinically significant cosmetic complication, with an incidence of 1 to 14 percent after glabellar injections in general populations and under 1 percent among experienced injectors. It is caused by diffusion of BTX-A through the orbital septum to the levator palpebrae superioris and typically resolves within 2 to 6 weeks.
A meta-analysis of 2,240 patients found that only 0.49 percent developed neutralizing antibodies to onabotulinumtoxinA. Purified formulations (Coretox, Xeomin) are theoretically intended to reduce this risk. The FDA has a Boxed Warning for all BTX-A products regarding distant spread of toxin effect, though no definitive serious adverse events linked to standard cosmetic doses at labeled indications have been reported in controlled data.
Korea vs US availability
Per 모두닥 (Modoodoc) 2026 platform data, typical Seoul pricing ranges from approximately ₩19,000 to ₩55,000 per area for domestic brands such as 원더톡스 and 코어톡스, and up to ₩190,000 for Allergan Botox. Masseter (jaw) injection starts from ₩19,000.
The US average per the American Society of Plastic Surgeons 2023 fee data is approximately $435 per treatment, with typical out-of-pocket ranging from $300 to $600.
Korea's botulinum toxin market is the largest in Asia by revenue and was valued at approximately USD 194 million in 2023, projected to grow at 10.4 percent CAGR through 2030. International clients visit Korea for dramatically lower pricing on domestic brands. Koreans drive domestic demand through high-frequency repeat visits, enabled by price competition among approximately 18 competing brands.
What to research before
- Verify the brand and the operator. A Korean clinic listing "보톡스" without a brand name could be using any of more than a dozen domestic products. Ask which specific brand is being used and confirm at the appointment.
- Be aware of the Meditoxin license history. Meditoxin 50U/100U/150U formulations were revoked by MFDS in 2020. Active product lines from Medytox today (such as Coretox and the 200U Meditoxin formulation) were not revoked, but the history is worth knowing.
- Confirm the clinic and injector are licensed. Our credential verification guide covers the relevant Korean specialty registries.
- See also: our Korean Surgery Safety Guide.
Related procedures
- HA fillers — volumizing dermal filler with a different mechanism
- Masseter reduction — common Korean BTX-A indication for facial slimming
- Skin boosters — adjacent injectable category for hydration and texture
- Thread lifts — alternative non-surgical lift modality
Sources
- PMC / Advances in Dermatology. The Whole Truth About Botulinum Toxin, A Review. 2019. https://pmc.ncbi.nlm.nih.gov/articles/PMC7874868/
- PMC / Cureus. Management of Complications Following Botulinum Toxin Facial Injections. January 2026. https://pmc.ncbi.nlm.nih.gov/articles/PMC12865869/
- Korea JoongAng Daily. Medytox Loses Sales Licenses. June 18, 2020. https://koreajoongangdaily.joins.com/2020/06/18/business/industry/Medytox-Meditoxine-botox/20200618195600274.html
- Aetion Evidence Hub. CDER-Approved BLA for Jeuveau. February 2019. https://evidence-hub.aetion.com/fda-decision-alerts/cder-approved-bla-for-jeuveau-prabotulinumtoxina-xvfs
- 시티호퍼스 (Cityhoppers). 강남언니 market overview. 2024. https://www.cityhoppers.co/p/924
- 모두닥 (Modoodoc). 보톡스 가격정보 2026. https://www.modoodoc.com/blog/price-detail
- ASPS 2023 Cosmetic Procedures Average Cost. https://www.plasticsurgery.org/Documents/News/Statistics/2023/cosmetic-procedures-average-cost-2023.pdf
- H&I글로벌리서치 (H&I Global Research). South Korea Botulinum Toxin Type-A Market. https://www.globalresearch.co.kr/insight/south-korea-botulinum-toxin-type-a-market-gvr/