I Tried It: Lower Face Tox
Relaxing a muscle to get a lift may sound counterproductive, but it does work.
I’ve been conservative with neuromodulators (Botox, Dysport, Jeuveau, etc.). I didn’t start getting injections until I was almost 42 years old (I’m now 44), and until recently, I had only dabbled in the eye and brow area twice a year. I’ve had neurotoxin injected into my glabella to soften my 11 lines, in the brow area to create lift to reduce the look of heavy eyelids, and in the sides of my eyes to relax the crow’s feet. (I currently have no toxin in my forehead because I don’t have static lines there.) But I hadn’t ventured below the eyes.
Then I turned 44. I firmly believe in the recent scientific theory that humans have an accelerated burst of aging around 44 (and again at age 60) because one morning, I looked in the mirror and thought, ‘What the @#&! is going on with my lower face?’ Almost overnight, I was starting to see marionette lines form. These are not wrinkles but more like divets or creases along the chin area, contributing to a saggy, jowling effect in the cheek and jawline. I contacted Kavita Mariwalla, MD, a renowned cosmetic dermatologist based in West Islip (and Pretty Local Advisory Board Member). Her response?
“A little neuromodulator in your DAO will help soften and lift everything.”
Dr. Mariwalla explained that DAO stands for Depressor Anguli Oris, a muscle that runs along the corners of the mouth and lower jaw. “As we age, we tend to pull down more with that muscle, and as the DAO descends, everything else starts to hang, creating a jowling effect,” she says. “If we put toxin where that muscle pulls down the corners of your mouth, then the compensatory muscle stays active; you won’t get that pull, so you’ll get rid of the joker’s creases or marionette lines.” The toxin relaxes the corners of the mouth, so they’re more neutral and not downturned.
I was game, so I made an appointment at Mariwalla Dermatology in West Islip. Dr. Mariwalla used Jeuveau, a neurotoxin that is said to have a quicker onset than others. Here’s what I learned about DAO tox:
It lasts about three months. Unfortunately, unlike other areas of the face, you won’t require less toxin over time. (This is the case with the glabella.)
The units needed will vary from person to person and brand to brand, but it’s typically on the lower end. “You want to do a low, tight concentration because if it diffuses into the depressor labii inferioris (DLI), a muscle that moves the lower lip downward, you can end up with a crooked smile, says Dr. Mariwalla.
This is not a treatment to get from a novice injector because of the risk of diffusion. You need to see an injector who thoroughly understands facial anatomy.
You may need more units on one side. Once my Jeuveau kicked in, I saw it worked better on the right. When I went for my follow-up appointment (very important to do!), Dr. Mariwalla injected more on my left side, where I naturally pulled stronger.
It costs, on average, between $150 to $250 to have this muscle injected.
Some people benefit from a bit of filler in that area, too, Dr. Mariwalla says. For others, treatments that restore lost collagen, such as microneedling and Sofwave, may help improve the appearance of the lower face.
Don’t expect face-lift-like results. “It’s a very nuanced kind of injection, but it makes a big difference for people in a subtle way. You often don’t realize it until you look back and you’re like, “‘Wow!’”
That last point was precisely my experience. It wasn’t until I compared a “before” photo with my “after” that I could see a noticeable difference. Check out my results below. I took the first picture in the office with clinical lighting (read: unflattering). The “after” picture was taken in front of a window (nature’s ring light) with more makeup, but no filter was used on the photo. I also had Jeuveau injected into my glabella, brows, and lateral side of my eyes for crow’s feet, resulting in an overall refreshed look.
Bottom line: The effect of my lower face tox is subtle but noticeable. I even see a difference in the nasolabial folds, which weren’t treated. Even after adding additional units, the toxin still worked better on my right side because of my natural asymmetry there. I pull harder with the DAO on that left side, but it is better and softer than it was. I will be back in three months to get my DAO injected again!
Before and after DAO injection (as well as glabella, brows, and crow’s feet).
