Can Botox injected directly underneath the chin help make the area less round like a bullfrog? (Photos)

Question

Just curious if this will make the under chin area hang lower, or does it make it tighter, lifted like your pulling your tongue up to cause a flat appearance. I just had it done 5 days ago & it bruised at the crease of neck/chin & it looks more puffy than it used to. But it al.ost feels like the muscles are tight but protruding if that makes any sense.

Nelson Lee Novick, MD · Answer

I have been injecting Botox into the platysmal muscles within the neck to smooth neck cords since the early 1990s. This technique was much later combined with additional Botox injections along the posterior two-thirds of the jawline, in what became known as the "The Nefertitii Lift" for reducing neck cords and for tightening and better defining the jawline. Botox works by weakening the downwardly pulling muscular hyperactivity in the injected muscles, thereby conferring a competitive advantage to surrounding upwardly pulling ones leading to skin tightening and "chiseling" of the neck/chin profile. However, your photo (and even HD photos are never as good as an in-person examination that allows for palpation and manipulation of the skin) suggests that your problem is one of excess fatty tissue under the chin. Although there are those that prefer the use of Kybella, an injectable fat dissolver, for this problem, I find that many patients do not appreciate the intense "bull-frog"-looking swelling and tenderness that follows the use of this substance and which can last up to two weeks at a time or sometimes even longer. I have instead found simple, much less expensive cannula subcision of this region to be a very effective approach for breaking up the unwanted fatty tissue and promoting a fibrous tissue tightening, which improves the cervical-mental (neck-chin) angle. Cannula Subcision was an outgrowth of submental liposuction where it was surmised that the skin tightening that was often seen following this procedure was actually due in at least in part to the subcising of the tissue by the liposuction cannula itself, which in turn led to the formation of fibrosis and overlying skin tightening. In general, there is very little visible swelling following this approach (which is greatly appreciated by patients) and hence little significant downtime to the extent that people typically can return to work immediately following treatment. Most often three to four treatment sessions (typically takes five minutes or so to perform) spaced at no fewer than six week intervals is needed to achieve optimal improvement. I performed this technique on three patients just yesterday alone. You would be wise to seek consultation and treatment by a board certified aesthetic physician. Best of luck.

Alexander Rivkin, MD · Answer

Hello and thank you for your question.  It can take 7-10 days to see the full results from your treatment. It is hard to say without an in-person examination, but some people do benefit from having Botox placed under the chin to help give a slightly lifted and tighter appearance.  Hope this helps.

Ramandeep Sidhu, MD · Answer

Botox for under the chin doesn't help with tightening. Neck treatment is dependent upon the fat and if there is fat then coolsculpting or kybella are the options and if its just laxity then ultherapy works great.

Monika Soni, MD · Answer

Thank you for your question. I believe the right treatment for you is Kybella, which is an injectable indicated for fat reduction under the chin. Botox would not be effective in the reduction of fat under the chin. I recommend consulting with a board-certified specialist who is experienced with Kybella injections for more information regarding which procedure is right for you. Best of luck!

Alex Eshaghian, MD, PhD · Answer

Thank you for your question and for sharing your photographs lagavulinx. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without knowing the dose used and placement of the product. However, I hope the information provided here is useful.Botox can also be used in various areas in the lower face. Botox can be placed in the mentalis muscle on the chin to address a cobblestone appearance or dimpling on the chin. In this area 2-8 units of Botox are used. Botox can be placed just under the jawline in what is called the Nefertiti lift to relax the platysma muscle which pulls down on the lower face, thereby improving jawline definition. When placed lower in the neck Botox can address vertical neck bands. Approximately 10 units are used below each jaw and in each band.If I had a patient who looked like the person in these photographs I would say she is also a good candidate for laser skin tightening of the neck as well as Kybella.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

Michele S. Green, MD · Answer

Botox in the neck area can help tighten the neck and make it look rejuvenated.  You would also benefit from Thermage to tighten the area of the jowls and Kybella works to reduce the area of fat under the chin.  An in person consultation is necessary to evaluate the area to help you.  Best, Dr. Green

Harlow Hollis, MD · Answer

The simple answer is “no “.  Botox only relaxes muscles that it is placed into. Nothing else. By weakening some muscles in the face, other muscles may appear more powerful and give a change to certain areas. But basically the answer to your question is still “no “  There are some other options that you might want to consider that could help you in this region. .

Shaun Patel, MD · Answer

Botox injection to the neck does not tighten skin. It does help with platysmal bands and this maybe why you had the injections. With regards to skin tightening, nonsurgical devices like Thermage FLX and Ultherapy can help. If submental (below chin) fat is the issue, then Kybella, CoolSculpting or certain lasers may be helpful.

Chester F. Griffiths, MD, FACS - Account Suspended · Answer

Thank you for sharing your question. I believe the right treatment for you is Kybella, which is an injectable indicated for fat reduction under the chin. Botox would not be effective in the reduction of fat under the chin. I recommend consulting with a board-certified specialist who is experienced with Kybella injections for more information regarding which procedure is right for you.

Can Botox injected directly underneath the chin help make the area less round like a bullfrog? (Photos)

Answers (9)

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