Can Botox be used to lift the cheeks and middle of the face?

Question

I always hear about Botox being used in the forehead region and near the chin and jaw. I have never heard of Botox being used in the middle region of the face. Are there any muscles in this region that can be targeted as a means of prevention or lifting?

Kenneth Hughes, MD · Answer

Hello, thank you for your question. Botox is most often injected into the upper part of the face. Most commonly, it is used to perform a modest "chemical brow lift" or to treat unwanted wrinkles caused by repetitive movement including frown lines, forehead lines, bunny lines, and crow's feet.  In the lower face, Botox is used to treat certain dimples and depressions on the chin, to minimize the appearance of vertical lines and wrinkles around the mouth, and to elevate a down turned corner-of-the-mouth. In the neck, Botox is typically used to reduce prominent platysma bands (neck cords).
Although Botox has many wonderful applications it is not a cure-all treatment and its use in certain parts of the face carries a slightly greater risk of complication. As always, safe and effective treatment is best in the hands of a qualified, experienced, and dedicated aesthetic physician.

Jason Emer, MD · Answer

Thank you for your question, Volume and contouring of the cheeks can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. Implants or fat are alternatives. Botox and radiofrequency can help slim and contour the jawline. Liposuction can help slim the face. Ultherapy, J Plasma and rf treatments can provide skin tightening and lift. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Nelson Castillo, MD · Answer

Thank you for sharing your question.  Botox does not provide lift to the cheeks and placement within the middle of the face may lead to weakening or paralysis of the muscles responsible for key facial animation and lip motion.  Hope this helps.

Nirmal Nathan, MD · Answer

Dear Trustworthy7460,Botox can be used all over the face and body when done by an experienced, qualified injector who understands the anatomy. That being said, the middle of the face is usually not a targeted area. Why? Because the Botox can diffuse to the muscles which control smiling. Inactivating these muscles will inadvertently produce an asymmetrical smile. The best interventions for the mid face are filler, fat grafting, and surgery.Hope this helps,Nirmal R. Nathan, M.D.
  
Certified, American Board of Plastic Surgery
  Member, American Society of Plastic Surgeons
  RealSelf Top Doctor

Scott D. Holley, MD, FACS · Answer

Hello and thank you for your question! Botox blocks the chemical connection between the nerve and the muscle, paralyzing the muscle to help relax wrinkles. The only way to get a “lift” from botox is to relax a muscle where the counteracting muscle will continue to contract and can allow for a small lifting effect-  this is sometimes done in the eyebrow to help with peaking. Botox is not used in the mid-face, however, dermal fillers are used in the mid-face to provide volume restoration and lifting. For example, injecting filler into the cheeks will help “lift” the cheek and reduce the prominence of nasolabial folds. I would recommend seeing an experienced injector that can explain the difference in treatments and help you reach your goals.  I hope this helps!

Gordon Andan, MD · Answer

Great question. The reason why BOTOX® is most commonly used in areas like the forehead and jawline is that it temporarily relaxes facial muscles—such as those that create frown lines and the masseter muscles at the jawline. Using BOTOX in the mid-face area could relax the muscles that control smiling and other facial expressions, creating an undesirable result.

Dermal fillers are more commonly used in the cheek area to both smooth away lines and wrinkles and provide added volume, which can have the “lifting” effect you’ve mentioned.

Dermal fillers are more commonly used in the cheek area to both smooth away lines and wrinkles and provide added volume, which can have the “lifting” effect you’ve mentioned.

Shaun Patel, MD · Answer

Neuromodulators are not commonly used in the midface. Typically volume loss in the midface/cheeks is improved using fillers. Addressing the volume loss can "lift the face".

Shelin Tkatch, MD, FRCSC · Answer

Botox relaxes muscle activity, and in the mid face the muscles are responsible for facial animation including smiling. Relaxing mid face muscles will not give a visually appealing result. Fillers, however, are very helpful for replacing lost volume, creating lift and enhancing mid face features, including cheeks and lips. During your consultation with your provider, they should review a variety of treatment options available for your concerns and assist you to pick the treatments best suited to your goals, lifestyle and budget. Best, Dr. Tkatch

Center for Aesthetics and Plastic Surgery - Grand Rapids · Answer

Hello there,
    Botox relaxes muscles, and inherently does not provide any lifting. Any "lift" provided by Botox comes from it relaxing muscles that counteract other muscles, allowing a lifting affect from the muscle movement counteracting. There are other treatments that can help with "lifting" in this area. Filler can provide structure and volume, giving a lifting affect. I also recommend Ultherapy or Exilis Ultra for stimulating deep collagen and elastin. Combining filler and these treatments will maximize the results. Hope this helps. 
Sarah RN BSN

Camille Cash, MD · Answer

Botox is not the right product to lift the mid face/cheek area.  However fillers do a very nice job of using volume to lift and contour the face.  Other treatments such as Silhouette InstLift are also options.  See a board certified plastic surgeon in your area to learn more.

Can Botox be used to lift the cheeks and middle of the face?

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