Botulinum Toxin Type A for the Management of Lower Face and Neck Lifting: A Systematic Review

Botulinum toxin type A (BoNT-A) injections are an effective, minimally invasive approach for elevating soft tissues in the lower face and neck. This systematic literature review seeks to address a standardized injection protocol-specifically, treatment areas, dosages, and outcome measures-by analyzing and synthesizing existing data. A comprehensive systematic search was conducted across multiple databases, including the China National Knowledge Infrastructure, PubMed, Web of Science, and EBSCO, covering publications from their inception through September 2025. Articles were evaluated based on predetermined eligibility criteria, and out of 1843 unique articles, 11 were selected for data extraction. The articles provided data on study characteristics, participant demographics, intervention specifics, outcome measures, and key findings concerning the application of BoNT-A in lower face and neck lifting procedures. Intradermal or subdermal injections of BoNT-A along the mandibular margin are mainly used to elevate the lower face and neck. The most frequently administered dose at each injection site is 2 U of Botox. Overall, patients reported high levels of satisfaction with the results of BoNT-A treatment for lower-face and neck lifting, with effects lasting up to 12 weeks. Intradermal or subdermal administration of Botulinum Toxin Type A (BoNT-A) along the mandibular margin has demonstrated efficacy in producing lifting effects in the lower face and neck. Further investigation is essential to establish consistent and objective metrics for accurately assessing the effects of lifting.