Jawline Botulinum Toxin

What is jawline botulinum toxin?

Jawline botulinum toxin is a procedure based on temporarily reducing the downward pulling action of the muscle in the area that runs along the jawline and merges with the muscle at the surface of the neck. Whether any change in appearance is possible is assessed at the examination.

The substance used in this procedure, which is popularly known by a brand name, is botulinum toxin. Botulinum toxin is a prescription-only medicinal product for human use (opens in a new tab) that temporarily reduces contraction in the muscle to which it is administered. The procedure is performed with an authorised product, within the terms of use in its authorisation, and by a physician.

How are the procedures around the jaw distinguished from one another?

Three separate areas around the jaw have their own pages. To avoid confusion:

These three areas are adjacent to one another and are assessed together at the examination. Which of them the procedure is performed on, and to what extent, is decided one area at a time.

The limit of what can be expected: This procedure is not directed at skin laxity, fatty tissue or bone structure. Where laxity is advanced, the expected contribution is limited, and an assessment by the relevant surgical specialty may be needed.

The procedure is performed at the practice (opens in a new tab) by Dr. Suzan Alp, Specialist in Internal Medicine.

Which factors determine whether the procedure is suitable?

The decision on suitability is made at the end of the examination. The decisive factors in the assessment of this area are:

• Whether the muscle at the surface of the neck becomes prominent when it contracts
• The degree of skin laxity and the state of the fatty tissue
• Movement of the corner of the mouth and of the lower lip during smiling
• The state of the neighbouring areas (the tip of the chin, the chewing muscle and the neck)
• Procedures previously performed in the area and any history of surgery to the neck or jaw region

In which patients is the procedure not performed?

• In patients with a disease affecting the neuromuscular junction (myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis and similar conditions)
• In pregnant and breastfeeding patients
• In patients under 18 years of age
• In patients with a history of allergy to the product to be used or to its components

Situations that require separate assessment

• Muscle disease (an assessment by the relevant specialist physician is required)
• Use of medicines that affect neuromuscular transmission (aminoglycoside antibiotics, muscle relaxants and similar)
• Bleeding or clotting disorder, or use of blood-thinning or anticoagulant medicines
• Active infection or febrile illness (the procedure is postponed)
• A recent procedure in the same area (the timing is adjusted accordingly)

Additional conditions specific to this area

The procedure is not performed if the following are present in the area to be treated:

• Difficulty swallowing
• Weakness in the neck muscles or difficulty with head control
• Active infection or an open wound
• Swelling, a mass or an enlarged lymph node whose cause has not been assessed (this needs to be assessed first)

In these situations, the procedure is planned subject to the physician’s assessment:

• A speech disorder (the opinion of the relevant specialist is sought)
• A history of facial palsy (the opinion of the relevant specialist is sought)
• Asymmetry of the smile (the possibility that it may increase is discussed beforehand)
• A previous surgical procedure to the neck or jaw region (the opinion of the relevant specialist is sought)
• Previously applied dermal filler in the area (timing and planning are adjusted accordingly)

How is the procedure performed?

1. Assessment. How the muscle at the surface of the neck behaves on contraction, the degree of skin laxity and movement of the corner of the mouth during smiling are assessed. Any complaint relating to swallowing, speech and head control is asked about. The neck is examined for swelling or a mass. Any history of neuromuscular disease, current medication, allergies and previous procedures are recorded. Blood pressure and pulse are measured.
2. Product check. The marketing authorisation status of the product to be used and its compliance with the storage conditions are checked.
3. Information and consent. The procedure, the limit of the expected contribution, the fact that the effect is temporary, the possibility of asymmetry of the smile and of difficulty swallowing, and the possible side effects are explained in writing and verbally; the form is signed.
4. Preparation. There must be no make-up on the area. Antisepsis is ensured.
5. Administration. The product is administered to the determined points with a fine needle.
6. Observation and follow-up. Vital signs and anything observed are recorded in the file. A follow-up appointment is arranged at which the outcome will be assessed.

When does the effect begin and how long does it last?

The time it takes for the effect to appear varies from person to person; the full outcome is assessed between a few days and two weeks. The effect is temporary, and how long it will last cannot be stated in advance. The timing of any repeat is determined at the follow-up.

What should you do before and after the procedure?

Before the procedure, report:

• A list of all the medicines and supplements you use (in particular blood thinners, painkillers and antibiotics)
• Your known allergies
• Any history of nerve or muscle disease
• Your pregnancy and breastfeeding status

If you have any complaint relating to swallowing, speech or the neck muscles, please mention it at the start of the consultation.

Come with no make-up on the area.

After:

• The area must not be massaged or rubbed on the day of the procedure
• Take care with eating and drinking in the first few days
• For a while, avoid tight-collared clothing that presses on the neck
• You are asked to avoid bending forward, remaining head-down for long periods and lying face down for the period of time given
• Avoid hot environments, saunas, sunbeds and intense exercise for a while
• Temporary raised bumps, redness and mild bruising may occur at the points of application

Recommendations specific to you, and the periods of time involved, are given in writing at the end of the procedure.

Risks and side effects

Risks specific to this area

• Asymmetry of the smile and unexpected movement at the corner of the mouth (outcomes that require care in jawline botulinum toxin)
• A change in the movement of the lower lip
• Difficulty swallowing
• A feeling of weakness in the neck muscles
• A temporary change in speech
• A feeling of tightness or heaviness in the area
• The expected change not being seen (where skin laxity is marked, the outcome is limited)

General risks that may occur with any minor procedure

• Pain, redness, swelling and bruising
• Infection at the site of the procedure
• Headache
• A change in facial expression
• An allergic reaction
• Flu-like symptoms
• Vasovagal syncope (fainting)

These side effects are temporary; however, the time they take to resolve varies from person to person and may take weeks. It is not possible to reverse the effect of the botulinum toxin.

Results vary from person to person.

When should you see a physician without delay?

If you experience these symptoms during treatment, contact your physician without delay:

• Marked asymmetry of the smile
• Increasing redness, increased warmth, swelling or discharge at the site of the procedure
• A high fever
• Widespread rash, itching

In the event of difficulty swallowing, disturbance of speech, double vision, shortness of breath, difficulty holding the head upright, widespread muscle weakness, or swelling of the lips or eyelids, go directly to the emergency department.

Frequently asked questions

Is jawline botulinum toxin enough for sagging?

This procedure is not directed at skin laxity, fatty tissue or bone structure. Where laxity is advanced, the expected contribution is limited, and an assessment by the relevant surgical specialty may be needed. Which clinical picture applies is determined at the examination.

Will my smile change after jawline botulinum toxin?

Asymmetry of the smile and unexpected movement at the corner of the mouth are the outcomes in this area that require the most care. For this reason, movement of the corner of the mouth and of the lower lip during smiling is assessed before the procedure.

Will my swallowing be affected?

Difficulty swallowing is among the side effects reported in this area, and the procedure is not performed in people who already have difficulty swallowing. Care with eating and drinking is recommended in the first few days after the procedure; if difficulty swallowing arises, a physician should be consulted without delay.

I have swelling in my neck; can I still have the procedure?

In those with swelling, a mass or an enlarged lymph node in the neck, this needs to be assessed first. The finding needs to be addressed before an aesthetic procedure is planned.

How long does the effect of jawline botulinum toxin last?

The effect is temporary and its duration cannot be stated in advance. It varies with the individual, muscle strength and the pattern of procedures. The timing of any repeat is determined at the follow-up consultation.

Is jawline botulinum toxin performed during pregnancy?

No. The procedure is not performed during pregnancy or breastfeeding.

Sources

1. Ministry of Health of the Republic of Türkiye, Turkish Medicines and Medical Devices Agency, Beşeri Tıbbi Ürünler Ruhsatlandırma Yönetmeliği, Official Gazette 11 December 2021 / 31686. https://www.resmigazete.gov.tr/eskiler/2021/12/20211211-5.htm (opens in a new tab)
2. Ministry of Health of the Republic of Türkiye, Ayakta Teşhis ve Tedavi Yapılan Özel Sağlık Kuruluşları Hakkında Yönetmelikte Değişiklik Yapılmasına Dair Yönetmelik, Official Gazette 7 January 2025 / 32775. https://www.resmigazete.gov.tr/eskiler/2025/01/20250107-3.htm (opens in a new tab)