Looking for advice on sagging skin near jawline. Lower face is looking square. Are dermal fillers or Botox an option? (Photo)

Thank you for sharing your photo and your questions. It’s very common to notice changes in the lower face as we age, including sagging skin or a squarer jawline. The good news is that there are non-surgical ways to address this.

Here’s a breakdown:

Dermal fillers near the cheekbones: Adding volume to the midface can help lift the lower face, soften the jawline, and reduce the appearance of sagging. This is often the most effective approach for improving facial contour and creating a subtle, youthful lift.

Masseter muscle Botox: This can slim a square jaw caused by a larger masseter muscle (often from teeth clenching or grinding). Botox in this area won’t lift sagging skin, but it can help reshape the jawline if the square appearance is muscular rather than due to tissue laxity.

Combination approach: Sometimes, using midface fillers to lift and Botox for jaw slimming can give the best overall contouring result.

In short, if the main concern is sagging and loss of lift, fillers in the cheek and midface area are typically more helpful. Botox in the masseter is more about reshaping the jawline than lifting the skin.

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. Sagging skin near the jawline and a more squared lower face can often be improved with a combination of Botox and dermal fillers, depending on the cause. If the heaviness or squaring is due to enlarged jaw muscles (masseters), Botox can be injected into those muscles to slim and soften the jawline by relaxing them over time. If the sagging is more from volume loss or skin laxity, fillers can help by restoring structure to areas like the cheeks, chin, and jawline, providing subtle lift and contour. For mild to moderate jowling, strategically placed fillers along the jawline and in front of the ear (the preauricular area) can create a more defined, lifted appearance. However, if there’s significant skin laxity, non-surgical tightening treatments (like radiofrequency microneedling) or surgical options may give better results. I hope this helps and best of luck!

At least from the one front-face photo provided (a profile view would have been additionally helpful), there appears to be volume deficit in the lower cheek region. In such a case, the use of a robust HA volumizing filler injected in the region of the posterior angle of mandible, as well as along the jawline, would provide lift and would help to better define and straighten the sagging and jowls along the jawline. If still necessary, Botox can be injected in small boluses along the jawline and along the upper neck to further straighten the jawline and diminish the appearance of sagging. You would be wise to consult with an experienced, board certified cosmetic dermatologist injection expert and best of luck.

Based on your post photo, you are better off with a mini face, neck lift, and muscle tightening than non-surgical fillers options. Best of virtual consult with for better explanation.

To help shape the lower face you have a few options. Botox injected into the masseter muscles can help slim the jawline. This is recommended if your muscle is hypertrophied. Fillers such as Volux can be used to sculpt the jawline. Other dermal fillers can be used to support tissues that lead to marionette lines. You can also consider treatments such as Morpheus8. This combines RF technology with microneedling to improve overall skin tone and texture.