Lower Face Treatments With Neurotoxins

DR. MUDGIL:  One of the most common reasons I see patients is to treat wrinkles with Botox. Now, Botox is a name brand. There are other toxins or neurotoxins that are on the market. Botox is one of them; Xeomin is another; Dysport is another. The newest one is Jeuveau. But for the purposes of this conversation, I’m just going to use the word Botox, because that’s kind of what everyone knows it as.

Botox, traditionally, is used to treat dynamic facial lines. Those are the lines of facial expression. The lines that you make between your eyes at the angry elevens, forehead wrinkles, and lines that are around the eyes, the crow’s feet. But some more advanced injectors use Botox to treat issues on the lower face.

One of the most common areas that I use Botox is on the chin. So some folks, if you notice, if you look at them very closely — and I’m looking at thousands of faces a year — you notice some dimpling of almost like an orange-peel look of the chin when the muscles of the lips are moving, kind of like when you pucker your lips, sometimes you can see some dimpling in this area here. When you apply a very small amount of Botox there, I’m talking about maybe four units, maybe five units tops, it relaxes those muscles. It relaxes the muscle that’s right here on your chin, and it causes that lower part of the face to kind of flatten out a bit. It also prevents the formation of dimpling when you move your lips.

I frequently couple chin Botox when I do filler on the lower face, because it really relaxes that part of the face, and it allows the filler to pop a little bit more. But just as a standalone treatment, if I have a couple of units of Botox left over, I’ll frequently inject it there. It’s a great place to use a couple of extra units of Botox if you have it.

Another very commonplace to inject Botox on the lower face is right here at the base of the jaw. And what that does is it softens a very strong jaw. Sometimes having a very strong jaw is a very masculine feature, it masculinizes a face. And when you can soften that muscle, it softens the jawline. It has a very, very nice cosmetic effect. Those are two of probably the only two places that you actually inject on the lower face.

Just as a corollary, you can inject Botox into the neck, and there are these bands of muscles, the platysmal muscle, when you stretch out your neck, and Botox can be used there as well. It’s not really the lower face, but it’s another place that some advanced injectors use Botox to soften dynamic lines or to soften muscles of facial expression.