Follow up question regarding full-face botox & “bullfrog” effect under chin.

Dr. Dean Kane Q & A. shutterstock_19810597 Q. I believe my recent full-face Botox, which included around my jawline, chin & platysma bands, affected the muscles under the chin/jaw area in a way which created what I call the “bullfrog effect”. In recent videos and photos of myself talking or laughing, the area under my chin/jaw clearly inflates beyond what’s normal for me. It makes me look heavy. Can more Botox be injected into certain muscles correct this? Or should I just “ride-it-out” for the next 3 – 4 months until the Botox fades away? A. ​You have “coined” a great name for this unusual effect! Thanks for sharing your photos. ​ ​I can see in the left photo that the medial platysma neck band is tight and in the right photo it is relaxed but along with it came the descent of the submandibular gland and therefore, your “bullfrog effect”. ​ ​Botox is used in many, many cosmetic and medically required areas of the body. Botox Cosmetic is primarily used in the forehead and brow region, and sparingly around the mouth and neck bands. ​ ​The idea of using it as a muscle relaxer of the platysma muscle along the jawline generated the invention of the “Botox Facelift” years ago. The idea was to allow the upper facial muscles to lift the face without the traction of the platysma muscle. This idea never really worked reliably. ​ ​Unfortunately, in your case, instead of defining your jawline, Botox relaxed the platysma muscle tone which had supported the submandibular glands and sublingual tissues (under the tongue) in their place and allowed them to fall. If injected deep to the muscle, the submandibular (salivary) gland will decrease production of saliva and you may feel your mouth is dry as a result.
  1. ​From the Botox perspective, allow normal muscle tone to return.
  2. ​From the perspective of your neck band and unsupported salivary glands, consider a platysmaplasty / neck suspension.
  3. ​Without the opportunity to see and examine you, you may consider a short scar face and neck lift; to additionally elevate the jowls, marionette folds, nasolabial folds and cheeks.
​ ​In any case, please consult with a Board Certified and well experienced Plastic Surgeon or Facial ENT Surgeon for proper examination and recommendations. ​ ​I hope this was helpful. All the best!
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