Botox for Jowls: Does It Really Work?

A firm, well-defined jawline is a key element of a youthful face. But over time, gravity and the natural aging process can lead to the development of jowls, the sagging skin below the jawline and chin. This can be a frustrating concern for many people. 

Are you noticing jowling or loose skin on your lower face? Discover why Botox–the neuromodulator better known for treating fine lines–might be a solution to consider. 

Understanding Jowls

Jowls are more than just a cosmetic concern–they signify a loss of elasticity and facial volume. Collagen and elastin, the building blocks of youthful skin, dwindle with age, and gravity joins the party to pull tissues downward and further blur a once-defined jawline. The result? A droopy appearance that can add years to your face.

What causes jowls?

Loose skin in the jowl area is caused by several factors. They include:

  • Aging: As we age, the equation for a youthful face gets thrown off balance. Our bodies naturally produce less collagen and elastin, two proteins that are essential for maintaining skin’s structure and elasticity. This decrease leads to skin laxity and volume loss, contributing to the development of sagging jowls.
  • Gravity: Gravity isn’t our friend when it comes to facial aesthetics. Over time, the constant downward pull of gravity on our facial tissues contributes significantly to the sagging of the jawline and the formation of jowls. Think of it like a tug-of-war – gravity pulls down, and with less collagen and elastin to resist, the skin gives way.
  • Genetics: Our genes play a role in how our skin ages, almost like a genetic shuffle that determines susceptibility to jowls. Some people are simply predisposed to have thinner skin or a faster breakdown of collagen, making them more likely to develop jowls earlier.
  • Sun exposure: Sun exposure is a major contributor to premature skin aging. The ultraviolet (UV) rays in sunlight break down collagen and elastin (another important protein for skin elasticity), accelerating the sagging process and the formation of jowls. Sun protection is key to keeping this collagen caper under control.
  • Lifestyle factors: Smoking, poor diet and lack of exercise can all negatively impact your skin’s health. These lifestyle factors can contribute to premature skin aging and the development of jowls. Think of it as a recipe for wrinkles and sagging – and jowls are definitely on the menu if you don’t make healthy choices.
  • Weight loss: Rapid weight loss, while great for your overall health, can leave you with excess skin on the body, including the neck, creating the appearance of jowls.

Now that we’ve covered the causes of jowls, let’s find out how Botox can help mitigate their appearance.

How Does Botox Work?

The botulinum toxin, marketed under brand names such as Botox, Dysport, Daxxify and Jeuveau, is a powerful tool for achieving a more youthful appearance. It’s a highly purified protein derived from the bacterium Clostridium botulinum. In microscopic doses, it’s used for various medical applications, most notably in relaxing muscles to treat conditions like chronic migraines and muscle spasms. In the field of cosmetics, Botox treatments are popular means of skin rejuvenation. 

When injected into a targeted muscle, Botox disrupts the communication between nerves and muscles. Normally, nerves send signals to muscles telling them to contract, which creates facial expressions like frowning or squinting. Botox temporarily blocks the release of a chemical messenger called acetylcholine, which is essential for muscle contraction. With acetylcholine blocked, the targeted muscle receives no signal to contract, resulting in a relaxation effect. 

This relaxation smooths out wrinkles and lines caused by repeated facial muscle movements, such as wrinkles around the eyes (crow’s feet), forehead lines and glabellar lines (“11s” between the brows). 

The effects of Botox injections are not permanent. As the body metabolizes the product, muscle function gradually returns, typically within 3-4 months.

Can Botox Treat Jowls?

In many cases, Botox can be strategically used to treat early jowls. Here’s how it works:

Prejowl Sulcus: The prejowl sulcus, appearing on either side of the chin, is a shallow divot marking the boundary between the tighter skin of the chin itself and the softer, looser skin of the jowl. This groove can be smoothed by relaxing muscles that form it to create a more unified jawline.

Chin: Botox injections can relax the muscles of the chin, reducing dimpling and slightly elongating the chin to disguise the appearance of jowls.

Jawline contouring: Relaxing the masseter muscle in the lower face can narrow it, sculpting a sharper jawline.

Platysmal bands: Platysma bands are vertical cords on the neck caused by tight muscles and sagging skin. They can be softened by relaxing the platysma muscle, enhancing the overall jawline definition.

The Nefertiti lift

The Nefertiti lift is a specialized aesthetic treatment named after the famous Egyptian Queen Nefertiti, famous for her striking jawline and smooth neck. Despite the name, it’s a non-surgical procedure that utilizes Botox injections to redefine the jawline and smooth the appearance of the neck. 

By relaxing platysma muscle strands that run down the neck and connect to the jawline, Botox relaxes these muscles, reducing downward pull and elevating these areas for a tighter, more lifted look. 

If you’re exploring non-surgical options to address early jowls and desire a more defined jawline, the Nefertiti lift might be an appropriate choice. However, for more pronounced jowls or significant sagging, combining this treatment with other procedures could be recommended for optimal results. 

Getting Botox for Jowls: What to Expect

Considering Botox to tackle early jowls? Here’s a rundown of what to expect:


Discuss your jowls and desired outcome with a qualified professional. They’ll assess your face, skin quality and jowl severity and review your medical history to see if Botox is the best treatment option for you.


It’s a quick in-office visit with minimal discomfort. Tiny needles inject Botox into specific jawline and lower face muscles, based on the consultation plan. The number of injections depends on your needs. 


Expect to see a sharper jawline within a week or two, with peak effects at 3 months.Remember, everyone experiences Botox differently. While some see significant improvement, Botox works best for mild to moderate jowls. If you have severe sagging, consult a professional to explore other options.


These improvements typically last 3-4 months, and repeat treatments are needed to maintain them.

Experiences vary. While some patients see a noticeable difference in jawline definition and reduced jowl appearance, Botox works best for mild to moderate cases. For severe sagging, a consultation with a qualified professional can help explore other options or a combination approach.

Side effects

Although Botox has an excellent safety profile and long history of use, it can cause temporary side effects including redness, swelling and bruising at the injection site. In some cases, temporary weakness of the targeted muscle may occur. These effects wear off as the Botox is metabolized.  

Alternative Jowl Treatments

Botox isn’t the only weapon in the fight against jowls. If you’re experiencing more severe jowling, consider these non-surgical and surgical options:

Dermal fillers

These volumizing substances plump the areas above jowls, creating a lifting effect. Many popular filler brands such as Juvederm and Restylane contain hyaluronic acid, a naturally occurring substance that holds many times its weight in moisture. Others, such as Sculptra and Radiesse, create a framework within your skin for new collagen to grow over time.

PDO threads

In this minimally invasive procedure, tiny threads are inserted into the midface or lower face to lift sagging skin. Sometimes called a non-surgical facelift, thread lift results may last from 6 months to over a year.

Radiofrequency microneedling

During this procedure, tiny needles emitting radiofrequency energy are stamped into the skin to stimulate collagen production and promote skin tightening over time.


If your primary concern is excess submental fat–AKA, a double chin–rather than loose skin, Kybella injections may be the best choice for you. It involves a series of injections of deoxycholic acid below the chin, which destroys fat cells and allows them to be naturally eliminated from the body.

Surgical procedures

For severe sagging, a consultation with a board-certified plastic surgeon can determine if a facelift or necklift is a more suitable option. Although a longer recovery period is necessary, and your skin will continue to age over time, plastic surgery is the most permanent solution available.


Jowls form due to sagging skin, a result of decreased elasticity, gravity and other factors. In cases of early jowling, Botox injections are a potential solution, offering a minimally invasive way to improve jawline definition. While it boasts minimal downtime and natural-looking results, Botox may not be suitable for severe sagging and can have temporary side effects.

If Botox isn’t right for you, other non-surgical treatments like fillers, thread lifts and radiofrequency microneedling offer temporary solutions, while plastic surgery can provide a more permanent reduction in jowling. 

Remember, for the most effective plan, consulting a qualified professional is key. They can assess your jowls and recommend the best course of action. With the right approach, you can achieve a more sculpted and youthful jawline.

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