5 ways to lift your lower face without surgery

When patients point at their jawline, they usually ask for filler. Often the lower face is being pulled, loosened and deflated all at once, and filler only fixes one of those. After more than 20 years of injecting, here are the five tools I use at HēBē Skin Health to lift the lower face and how I decide where to start.

Why does the lower face start to sag?

Four things change at once. The muscles that pull down, mainly the depressor anguli oris (DAO) at the mouth corners and the platysma in the neck, keep pulling every day. Skin loses collagen and elasticity. Fat pads shift and bone along the jaw and chin slowly resorbs, so there is less structure holding everything up. Each treatment below targets one of those layers, which is why the best results are with combination treatments.

1. Botox for the DAO and the Nefertiti neck lift

The DAO is a small muscle that pulls the corners of your mouth down. When it is strong, you can look tired or unhappy at rest. A few units of Botox placed in the DAO weaken that pull so the muscles that lift your mouth corners can win. A 2026 prospective study on drooping mouth corners found the effective dose scaled with severity, from about 3 units per side for mild cases to 12 units per side for severe ones.

The Nefertiti lift treats the platysma, the thin sheet of muscle that runs from your chest up over the jawline. Botox placed along the jaw and into the vertical neck bands reduces its downward pull, which can sharpen the jawline and soften neck bands. In October 2024 the FDA approved Botox Cosmetic for moderate to severe platysma bands, its first approved use below the face. DAO treatment is an off-label use that experienced injectors have performed for years.

Results typically start in 3 to 5 days and settle in by two weeks. Most people repeat every three to four months.

Best for: mouth corners that turn down at rest, a jawline that blurs when you talk, visible neck bands.

2. XERF radiofrequency skin tightening

Botox cannot tighten skin. When the issue is laxity along the jowls or under the chin, I reach for XERF. It is a monopolar radiofrequency device from Cynosure Lutronic that delivers two frequencies in a single pulse: 6.78 MHz for the dermis and 2 MHz, which reaches deeper toward the SMAS, the support layer a surgeon tightens during a facelift. The heat contracts existing collagen and starts a healing response that builds new collagen over the following months.

XERF received FDA clearance in the United States in 2025. A 2026 retrospective study reported improvements in facial skin laxity and skin quality with a favorable safety profile.

Best for: early jowling, crepey skin along the jaw and neck, patients who want a needle-free option.

3. MINT PDO thread lift

Threads physically reposition tissue. MINT threads are made of polydioxanone (PDO), a dissolvable suture material. Barbed threads are placed under the skin with a cannula, grip the tissue, and lift it into a better position along the jowl and lower cheek. MINT is the PDO thread line with three FDA clearances, including one for facial suspension.

The lift is visible right away. The threads dissolve over roughly six to eight weeks, and the collagen that forms around them helps results last up to about a year.

Best for: mild to moderate jowls in patients who want a visible lift without surgery.

4. Filler for the chin, jawline and marionette lines

As bone and fat change, the chin loses projection, a dip forms in front of the jowl (the prejowl sulcus), and shadows deepen at the marionette lines. Firm hyaluronic acid filler rebuilds that structure. A defined chin and an even jawline make jowls look smaller without touching them.

At HēBē we carry Juvéderm Volux and Restylane Lyft and Defyne, and I choose by area and tissue thickness. Volux was approved by the FDA in 2022 specifically for jawline definition, and Restylane Defyne is approved for the chin. Results are immediate, and hyaluronic acid filler can be dissolved if needed.

Best for: a weak chin, a jawline that has lost its edge, deep marionette shadows.

5. Sculptra to rebuild collagen

Sculptra is poly-L-lactic acid, a biostimulator. It does not fill on day one. It signals your skin to build its own collagen over the following months, which thickens and firms the skin that drapes over everything else. It is usually done as a series of sessions spaced several weeks apart. In Galderma's cheek-wrinkle study, 94% of patients were still improved two years after treatment.

Best for: thinning skin, gradual all-over firmness, patients planning ahead rather than fixing one spot.

Which lower-face treatment is right for me?

Nicole Smith, MSPA, at HēBē Skin Health.

Come see me for a consultation. Every lower face is different, and the right plan depends on things a photo or a blog post can't show: how your muscles move when you talk, how much your skin has loosened, and where you've lost structure along your chin and jaw. At your consult at HēBē in Laguna Beach or Claremont, I'll watch your face move, ask what bothers you most, and talk through your budget and timing. Then we'll build a personalized treatment plan together, whether that's a single treatment or a combination spaced over a few months, so you leave knowing exactly what I'd do first and why.

FAQ

Sources

1. FDA approves Botox Cosmetic for platysma bands, Healio, Oct 21, 2024
2. The Impact of Dosage and Injection Site on Type A Botulinum Toxin Treatment for Oral Commissure Ptosis, Aesthetic Plastic Surgery, 2026
3. Botulinum toxin applications in the lower face and neck: a comprehensive review, Journal of Cosmetic Dermatology, 2024
4. Objective and subjective retrospective evaluation of XERF, Lasers in Medical Science, 2026
5. MINT PDO, Manufacturer site
6. Juvéderm Volux XC, P110033/S065, U.S. FDA
7. Galderma receives FDA approval for Sculptra for cheek wrinkles, Galderma, Apr 26, 2023