Systematic Review: Botulinum Toxin Type A Linked with Lower-Face and Neck Lifting
Key Takeaways
A systematic review of 11 studies found that botulinum toxin type A (BoNT-A) injections produced lower-face and neck lifting effects, with high patient satisfaction.
Intradermal or subdermal injections along the mandibular margin were the predominant approach, with 2 U of Botox per injection site the most frequently reported dose.
Reported effects lasted up to 12 weeks; standardized injection protocols and objective outcome measures remain lacking.
A systematic review published in the Journal of Craniofacial Surgery suggested botulinum toxin type A (BoNT-A) injections produced lifting effects in the lower face and neck, with high patient satisfaction and reported effects lasting up to 12 weeks.
Investigators searched China National Knowledge Infrastructure, PubMed, Web of Science, and EBSCO for studies published through September 2025. Of 1,843 unique articles identified, 11 met eligibility criteria and were included in the analysis.
Botulinum Toxin Injection Techniques and Treatment Outcomes
Intradermal or subdermal BoNT-A injections along the mandibular margin were the predominant techniques used to achieve lower-face and neck lifting across the studies. The most frequently reported dose was 2 U of Botox per injection site. Patients generally reported high satisfaction with treatment outcomes. Lifting effects persisted for up to 12 weeks, according to the abstract.
The authors said there remains a need for standardized assessment methods to improve comparisons across studies and clarify treatment outcomes.
"Further investigation is essential to establish consistent and objective metrics for accurately assessing the effects of lifting," the authors concluded.
Source
Zhang B, Sha Z, Zheng Y. J Craniofac Surg. 2026. Doi:10.1097/SCS.0000000000013395