Best non-surgical options for early lower-face laxity and chin/neck softening? (Photos)

Question

40-year-old woman with generally good skin quality, but I’m noticing early aging in my lower face—specifically softening of the jawline, mild chin retrusion, and loss of definition at the chin–neck angle. I’m not looking for dramatic changes or overfilling and want to keep results natural. I’m interested in non-surgical options, particularly: Botox/Dysport to the DAO, platysma (Nefertiti lift), and mentalis Whether neurotoxins alone can meaningfully improve early lower-face descent If/when RF microneedling or Ultherapy would be more appropriate Whether small, strategic chin filler would be beneficial or premature I’d like to avoid jawline overfilling and anything that could worsen jowling. My goal is subtle tightening and improved profile, not volume. Based on my photos, what would you recommend as the best first step, and in what order?

Anna Chacon, MD, FAAD · Answer

Thank you for describing your concerns so clearly—you’re noticing very common, early lower-face changes, and your goal of subtle tightening (not volume) is exactly the right mindset at this stage.

From what you describe and based on the photos, your skin quality is good, and the changes appear to be more about muscle pull and early soft-tissue descent rather than true volume loss. That’s important, because it means you can get meaningful improvement without overfilling or aggressive treatment.

Here’s how I’d think about this, step by step:

1. Neurotoxins as the first step (yes, they can help here)

Used thoughtfully, Botox or Dysport can absolutely improve early lower-face descent, especially when the issue is muscular rather than structural.

DAO (depressor anguli oris):
Softening this muscle can reduce the downward pull at the corners of the mouth, subtly improving marionette shadows and preventing a “pulled” look.

Mentalis:
If there’s chin tension or dimpling, relaxing this muscle can smooth the chin and improve the chin–lip relationship without adding volume.

Platysma / Nefertiti lift:
This can help redefine the jawline and improve the chin–neck angle by reducing downward neck pull. Results are subtle but elegant when done conservatively.

For someone like you, neurotoxin alone can create a noticeable but natural refinement, especially early on.

2. Energy-based tightening: when to consider it

If laxity continues or you want more skin tightening than toxin alone can provide:

RF microneedling:
A good option if you’re starting to notice textural changes or mild skin looseness. It stimulates collagen gradually and works well for early laxity.

Ultrasound-based tightening (Ultherapy):
More appropriate when there’s mild–moderate laxity and you want deeper tissue tightening, particularly along the jawline and under the chin.

These are best considered after or alongside neuromodulators, not instead of them.

3. Chin filler: useful, but only if done sparingly

You mentioned mild chin retrusion, and in cases like this:

Very small, deep, structural chin filler can improve the profile and sharpen the chin–neck angle without causing heaviness.

This is about support and projection, not fullness.

It’s not premature if done conservatively—but it should come after muscle balance is addressed, not before.

Avoiding jawline overfilling is wise; in early aging, that’s often what worsens jowling rather than improves it.

Recommended order for the most natural result

Targeted neurotoxins (DAO, mentalis, platysma)

Reassess at rest and in motion once muscles are balanced

Add RF microneedling or Ultherapy if skin laxity persists

Consider minimal chin filler only if needed for structural support

The big picture

You’re catching this early, which is ideal. The goal isn’t to “fix” anything—it’s to rebalance muscle pull, preserve definition, and stimulate your own collagen so aging stays gradual and graceful.

Mats Hagstrom, MD (license on probation) · Answer

My first hand experience with DAO neurotoxin treatment hasn’t been all that great.
Primarily what I noticed is patients get a wider smile, but it doesn’t seem to lift the corners of the mouth in static position.I’ve had some patients who get the treatment regularly and seem to like it even though I don’t see that much difference.
I’ve had the treatment done to myself, and I didn’t think it was really all that great.
Neurotoxin treatment to the mentalis can soften the surface and some people think this is a worthwhile treatment.
It’s definitely worth trying if smoothness of your chin is desired.
Radio, frequency, micro, needling, and plain micro needling is done enough can make some pretty nice changes if you’re looking for a subtle change.
They’re also pretty safe so I think that’s a good place to start.
Do you recognize that in order for micro needling to work you have to do it a lot.
I’m reluctant to recommend radio frequency treatment because I have seen subcutaneous fat loss that causes severe premature aging.
It doesn’t happen most of the time but when it happens, it’s totally devastating.
When you add up the total expense and required ongoing maintenance for these lesser invasive treatments it works out well for some people but for others it’s a bit too much.
All of them are subtle and if subtle is what you’re looking for then recognize it’s not going to have a great impact because that’s what subtle means. 
Volume restoration is probably the greatest single treatment option in the mid and lower face.
The problem is finding a provider who is truly good at these treatments.
Average work tends to not be very impressive and finding and truly exceptional provider at volume restoration is not at all easy or straightforward.
 For reference, I recommend you check out the work being done by Mark Mabrie, MD in San Francisco, 
Real self doesn’t like me to include links to other websites so you’ll have to look it up yourself.
Mark has an incredible collection of before and after pictures of facial volume restoration done using only fillers.
His work is the best I’ve ever seen and I consider his outcomes to be the gold standard.
I’m not recommending everybody flight to San Francisco to get treatments from Mark but Seeing his results can be a powerful tool when it comes to judging other providers and recognizing what can be accomplished in the hands of the right provider.
Best,
Mats Hagstrom MD

Best non-surgical options for early lower-face laxity and chin/neck softening? (Photos)

Answers (2)

More Chin Liposuction Questions

WE SEND PRETTY
EMAILS

Answers (2)

More Chin Liposuction Questions

Honest feedback needed — what procedure could provide a subtle jawline and longer looking neck? (Photos)

Will my chin protrude more if i get chin lipo? Its not bone its soft tissue. (Photos)

What’s happening with my chin? Will filler or botox be enough or would I need neck lipo? (Photos)

Unsure what the lump under my chin is - Is it lipo that I need, or something else? (Photos)

I do not want fillers. How do I fix my chin? The coming out/down and definition of the back of the jaw? (Photos)

What are my options to tighten the skin under my chin? (Photos)

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS