Can Botox Help with Sagging Jowls?

As we age, it’s common to notice changes along the jawline - particularly a softening or sagging of the skin known as “jowls.” This can be due to a combination of factors including collagen loss, gravity, volume depletion, and increased muscle activity in the lower face and neck. While surgical procedures such as a lower facelift have long been considered the gold standard for addressing sagging jowls, many people today are looking for less invasive options that require little to no downtime. One treatment that often comes up in conversation is Botox!

So - can Botox actually help with sagging jowls? The answer depends on the cause and severity of the sagging, but in certain cases, the answer is yes! Here's what you need to know.

What Is Botox?

Botox is the brand name for a type of botulinum toxin, a purified neurotoxin that temporarily relaxes muscles when injected in small amounts. It works by blocking the nerve signals to a specific muscle, which reduces movement in that area.

Botox is FDA-approved to treat a number of aesthetic concerns, including forehead lines, frown lines between the eyebrows (glabellar lines), and crow’s feet. However, in advanced aesthetic practices, Botox is also used off-label to improve facial symmetry, contour the jawline, and subtly lift areas of the face affected by aging - when used strategically!

What Causes Jowling?

Before diving into how Botox can help, it’s important to understand what causes jowls in the first place. Jowling occurs when the skin and underlying soft tissue lose their elasticity and begin to sag along the jawline. Several factors contribute to this:

-Loss of collagen and elastin in the skin

-Volume loss in the cheeks and mid-face

-Repeated muscle movement pulling down on the lower face

-Gravity and natural aging

-Skin laxity and thinning over time

In many cases, jowls form due to a combination of these factors. That’s why treatment often involves more than one modality.

How Botox Can Help

In the case of mild to moderate jowling - particularly when there is muscular tension contributing to the appearance of sagging - Botox can play a helpful role!

The key muscle involved in this area is the platysma, a thin, superficial muscle that extends from the jawline down the neck. In some people, overactivity of the platysma can pull down the corners of the jaw and mouth, worsening the appearance of jowls and creating vertical neck bands.

Botox can be injected into targeted points of the platysma muscle to reduce this downward pull, allowing the facial muscles that lift the jawline to work more effectively. The result is a subtle lifting effect along the jawline and an overall improvement in the appearance of the lower face.

This approach is sometimes referred to as the “Nefertiti Lift,” named after the ancient Egyptian queen known for her defined jaw and elongated neck.

Where Botox Is Injected

When treating the jawline and neck for sagging, the most common injection sites include:

-Platysmal bands: Vertical bands on the neck that pull downward

-Jawline border: Small injections along the lower face help define and lift

-DAO (depressor anguli oris) muscle: In some cases, relaxing this muscle - responsible for pulling down the corners of the mouth - can enhance results

This treatment is not about freezing the face or changing how you look. The goal is to relax overactive muscles that are interfering with facial balance and harmony.

What Results to Expect

It’s important to set realistic expectations. Botox will not physically remove excess skin or replace volume loss. However, in appropriate candidates, it can improve the appearance of:

-Mild to moderate jowling

-Early skin laxity along the jawline

-Downturned corners of the mouth

-Vertical neck bands

-Lack of definition along the jaw

Results typically appear within 5 to 10 days after injection, with full effect seen by about 2 weeks. Improvements generally last around 3 to 4 months, after which treatment can be repeated to maintain the results.

Because Botox works by relaxing targeted muscles, the lift is subtle but effective—it’s more about restoring balance to the lower face than dramatically changing its structure. Many patients notice that their jawline looks more defined and their profile appears smoother, even though the change is gentle and natural-looking. Over time, consistent treatments can also help prevent further deepening of muscle-driven lines and sagging.

Who Is a Good Candidate?

Botox is most effective for patients in their 30s to 50s with early signs of jowling caused by muscle tension or mild laxity. Ideal candidates are those who:

-Are noticing a loss of definition along the jawline

-Have early skin laxity or neck bands

-Want a non-surgical option with minimal downtime

-Have realistic expectations about what Botox can and cannot do

For more advanced sagging or skin redundancy, other treatments may be recommended - either on their own or in combination with Botox.

What the Treatment Is Like

Botox injections for the lower face and neck are quick and minimally invasive. The treatment typically takes less than 20 minutes and requires no downtime. Most patients describe the sensation as a mild pinch, and any redness or swelling usually resolves within an hour.

You can return to work or your normal activities the same day. We do recommend avoiding vigorous exercise, lying flat, or applying pressure to the treated areas for at least 4 hours post-treatment.

The Bottom Line

Botox can absolutely help improve the appearance of sagging jowls - in the right context. If the drooping is caused by overactive muscles, early laxity, or dynamic pulling in the lower face, Botox can provide subtle but noticeable improvements. For more advanced cases, a combination approach may be more effective.

The best way to determine what’s right for you is through a personalized consultation. At Defy Aesthetic, we believe that aesthetic medicine should be thoughtful, evidence-based, and tailored to your individual goals.

Whether you're interested in filler, Botox/Dysport, collagen-boosting skin treatments, or want to learn more about our Defy Annual Membership (a perfect choice for those who want to transform their skin without the price tag over the course of a year!), we’d love to see you in our Bethesda medical spa soon.