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Botulinum Toxin Type A for the Management of Lower Face and Neck Lifting: A Systematic Review

This systematic review of 11 studies found that botulinum toxin A is mainly injected into or just under the skin along the jawline, most often at 2 U of Botox per site, to lift the lower face and neck, with high patient satisfaction and effects lasting up to 12 weeks.

2026
J Craniofac Surg
0
Citations, NIH iCite
3
Authors
1
Topics

Overview

The authors aimed to define a standard injection protocol for lifting the lower face and neck with botulinum toxin A: where to inject, how much, and how to measure results. They searched the China National Knowledge Infrastructure, PubMed, Web of Science and EBSCO from their start through September 2025. They screened articles against set criteria and extracted data on study design, patients, injections, outcome measures and findings.

Findings

  • 1843 unique articles found; 11 selected for data extraction.
  • Injections are mainly intradermal or subdermal along the mandibular margin.
  • The most frequent dose at each injection site is 2 U of Botox.
  • Patients reported high satisfaction with lower face and neck lifting.
  • Effects lasted up to 12 weeks.
  • The authors state further work is needed to set consistent, objective measures of lift.

What it means for a patient

  • Botulinum toxin injected along the jawline is a nonsurgical option aimed at lifting the lower face and neck.
  • The effect lasted up to 12 weeks in the studies reviewed.
  • Satisfaction was high, but the authors state consistent, objective measures of lift are still lacking.
  • Limits: only 11 studies, varied outcome measures, and no comparison with surgical lifting in the abstract.

Why this paper matters

It combines the studies on botulinum toxin for lower face and neck lift into one injection pattern and typical dose. It also shows the field lacks objective ways to measure lift.

Terms

  • Botulinum toxin type A (BoNT-A): a purified protein that relaxes muscles by blocking nerve signals; Botox is one brand.
  • Intradermal: injected into the skin.
  • Subdermal: injected just under the skin.
  • Mandibular margin: the lower edge of the jaw.
  • U (unit): the standard dose measure for botulinum toxin.
  • Systematic review: a study that searches for and combines all published research on one question using set rules.

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