Mid/Lower Face & Neck

Until more recently it was considered taboo to use Botox for cosmetic reasons on the mid and lower part of the face. This is because the lower facial muscles have more anatomical complexity than the upper facial muscles, which led to uncertainty about the dosage required and a greater risk of unwanted muscles being affected. This could result in uneven facial expressions and also effect things like chewing and speaking.

In the mid area of the face, the use of Botox is limited and very specific. Typically, fillers are used in this area to help fill in lines and wrinkles and return the volume to aging skin. Botox is most frequently used here to treat the bunny or Nasalis lines, which are wrinkles on the outer sides of the nose.

When it comes to the lower face, Botox is used not only to reduce lines but also to reduce creases by providing a “lift” in an age-affected area. This technique is now used in the smile creases running from side of the nose to the corner of the mouth, the nasolabial folds, to lessen their appearance, as well as in the corners of the mouth to fix a droopy, angry expression.

Another newer use for Botox in the lower face is for reducing the jowls and creating a smoother jawline. This is sometimes also referred to as the “Nefertiti lift.” Using Botox in the neck is not a new, but it was typically done differently in the past using large doses on large areas of the neck, which resulted in an expensive temporary treatment that had added risks of unwanted side effects such as swallowing and speech impairment, and even difficulty holding the head straight. The Nefertiti lift involves a more careful assessment of the musculature in the neck and lower face, which allows for much smaller doses (50 – 70% less) and fewer injections. This makes it a more affordable treatment, providing the same, or even better, results without the risk of side effects. Loose, sagging neck skin can also be improved by injecting Botox further down each vertical platysmal neck muscle band. This causes the looser envelope of skin to sit closer to the neck, providing a neck lift effect.