How to Get Rid of Jowls Without Surgery: Botox, XERF, Ultherapy and What Actually Works

By Beauty Ranch Medical Spa | Medically reviewed by Janee Malan, PA-C, board-certified Physician Assistant | Last updated September 11, 2026

Jowls are the soft pockets of skin and tissue that settle along the jawline as the lower face loses its support. They are one of the first things people notice in photos and one of the most common concerns we hear at Beauty Ranch. The good news: jowls are very treatable without a facelift, but only if you treat the reason you have them. Botox can do a lot for one type of jowl and almost nothing for another. This guide explains why jowls form, how Botox and Dysport work for jowls and when they are the right call, and when XERF, Ultherapy, Sculptra or threads will get you further.

Every jowl plan at Beauty Ranch is reviewed by Janee Malan, PA-C. Botox is a neuromodulator, which means it works on the nerve signals that control muscle movement. Janee's career emphasis includes neurology alongside plastic surgery and medical aesthetics, which is an unusual combination for an aesthetic injector and exactly the background you want for a treatment that depends on reading how the muscles of the lower face pull against each other.

• What Causes Jowls?
• Does Botox Work for Jowls?
• The Three Botox Techniques for Jowls
• When Botox Is Not Enough
• Which Jowl Treatment Do You Need?
• What to Expect From Botox for Jowls
• Botox for Jowls Before and After
• How Much Does Botox for Jowls Cost in Los Angeles?
• Why Beauty Ranch for Jowl Treatment in Los Angeles
• Frequently Asked Questions About Jowls
• Book a Jowl Consultation

Book a Jowl Consultation

What Causes Jowls?

Jowls form when three things happen at once, usually starting in the late 30s to 40s:

• Muscle pull. The platysma (the sheet of muscle in the neck) and the depressor anguli oris (DAO, the muscle at the corners of the mouth) pull the lower face downward every time they contract. Over years, that constant downward pull drags tissue over the jawline.
• Skin laxity. Collagen and elastin decline, so the skin along the jaw no longer snaps back.
• Volume loss. Fat pads in the mid-face deflate and descend, and the jawbone itself loses definition, so there is less structure holding tissue up.

Rapid weight loss, including from GLP-1 medications, speeds all three up, which is why jowls are a common part of what people call Ozempic face. Genetics, sun damage, smoking and a strong clenching habit (which enlarges the masseter and changes the lower face shape) all play a role too.

Knowing which of these is driving your jowls is the whole game. Muscle pull responds to Botox. Laxity and volume loss do not.

Does Botox Work for Jowls?

Yes, for the right person. Botox does not tighten skin or add volume. What it does is relax the muscles that pull the lower face down, so the muscles that pull it up win. When the downward pull is a big part of your jowls, usually in your late 30s to early 50s with mild to moderate jowls and reasonably good skin, Botox gives a visible improvement in jawline definition within two weeks. Our full guide to Botox in Los Angeles covers dosing and pricing in more detail.

If your jowls are mostly loose skin or lost volume, Botox alone will disappoint you. That is where the treatments further down come in, often combined with Botox rather than instead of it.

The Three Botox Techniques for Jowls

Botox for jowls is not one injection. It is a combination of up to three techniques, chosen based on your anatomy.

The Nefertiti Technique (Platysma Botox)

Named after the Egyptian queen's famously sharp jawline, the Nefertiti technique places small amounts of Botox along the jawline and into the vertical bands of the platysma muscle in the neck. Relaxing the platysma removes its downward pull, which lets the jawline sit higher and look more defined. It also softens neck bands. Typical dosing is 20 to 50 units total, spread across many small injection points on both sides.

DAO Botox (Corners of the Mouth)

The depressor anguli oris pulls the corners of the mouth down and contributes to the marionette lines that run into the jowls. A few units on each side (usually 4 to 8) releases that pull and subtly turns the corners of the mouth up. It is a small injection with an outsized effect on how tired the lower face looks.

Masseter Botox

If you clench or grind, an enlarged masseter widens the lower face and makes jowls look heavier. Masseter Botox (typically 20 to 30 units per side) slims the jaw over 6 to 8 weeks and can improve the overall shape of the lower face, though it is not a jowl treatment on its own. Read our masseter Botox in Los Angeles guide.

Why the Injector Matters More Here Than Anywhere Else

Lower-face Botox is the most technique-sensitive Botox there is. The platysma, DAO, depressor labii and the muscles that control your smile all sit within millimeters of each other. Too much product or a slightly wrong placement can affect your smile or your ability to purse your lips for several weeks. This is why Beauty Ranch routes jowl and Nefertiti treatments through Janee Malan, PA-C. Her clinical background in neurology means she approaches Botox as what it actually is, a neuromodulator acting on the nerve-muscle junction, and she maps each patient's muscle pull before injecting. She holds master class certifications for Botox, trained with leading specialists in medical and aesthetic applications, and favors a conservative, natural result over an overdone one. Meet Janee and the rest of the team.

When Botox Is Not Enough: Treatments for Skin Laxity and Volume Loss

If your jowls are moderate or you are past your early 50s, pairing Botox with one of these gives a dramatically better result.

XERF (Best for Skin Tightening Without Downtime)

XERF is our most requested jowl treatment for good reason. It delivers radiofrequency energy deep into the skin to tighten the jawline and neck and rebuild collagen over three to six months, with no downtime. It treats the laxity component that Botox cannot, and it pairs perfectly with the Nefertiti technique: Botox stops the downward pull, XERF firms the skin. XERF starts at $2,500 at Beauty Ranch. Read our complete XERF treatment guide and what the XERF facelift is.

Ultherapy (Deep Tightening Along the Jawline)

Ultherapy uses focused ultrasound to heat the deeper support layer of the face (the same layer a surgeon tightens in a facelift) and is FDA cleared for the jawline, chin and neck. It is a strong choice for moderate jowls and for clients who want one treatment a year. Ultherapy starts at $2,500. See Ultherapy in Los Angeles and our Ultherapy cost guide.

Sculptra (Rebuilding Lost Volume)

When jowls come from deflation of the mid-face and jawline, adding structure back matters more than tightening. Sculptra stimulates your own collagen over several months and is placed along the jawline and pre-jowl area to restore definition. $1,000 per vial; most jawline plans use one to two vials per session. See our Sculptra guide.

PDO Threads (Immediate Repositioning)

PDO threads physically reposition tissue along the jawline for an immediate improvement, then dissolve while stimulating collagen. They suit clients who want a visible change the same day and are willing to accept a few days of swelling. PDO threads are $1,200. See our PDO thread lift guide.

Kybella (When Fullness Under the Chin Is Part of the Picture)

If submental fullness blurs the line between chin and neck, Kybella dissolves that fat permanently and sharpens the whole lower face. $600 per session. See our Kybella guide.

Which Jowl Treatment Do You Need? A Quick Guide by Cause and Age

Your situation	Likely cause	Best first step	Add for a bigger result
Late 30s to 40s, early jowls, good skin	Muscle pull	Botox: Nefertiti plus DAO	XERF for prevention
40s to 50s, moderate jowls, some looseness	Muscle pull plus laxity	Botox plus XERF	Sculptra along the jawline
50s and up, jowls plus neck laxity	Laxity plus volume loss	Ultherapy or XERF	Botox for the platysma, Sculptra
Any age, jowls after rapid weight loss	Laxity plus volume loss	XERF plus Sculptra	Botox, Kybella if needed
Wide lower face from clenching	Masseter enlargement	Masseter Botox	Nefertiti technique
Want a visible change today	Any	PDO threads	Botox two weeks later

How Beauty Ranch matches jowl treatments to cause and age. Your consultation confirms the plan. See also our guide to skin tightening in Los Angeles.

What to Expect From Botox for Jowls

The appointment takes about 20 minutes. Janee marks the platysma bands and injection points while you clench and relax, then places many small injections along the jawline, neck bands and corners of the mouth. There is no downtime; you can return to your day immediately. Avoid lying flat, rubbing the area or intense exercise for the first four hours. Results begin around day 4 to 7 and settle by day 14, then last three to four months.

Botox for Jowls Before and After: What Results Look Like

A well-done lower-face Botox treatment does not look like you had anything done. The jawline reads sharper, the corners of the mouth sit neutral instead of turned down, neck bands soften, and the "tired" or "heavy" quality of the lower face eases. Combined with XERF or Ultherapy, the skin along the jaw firms progressively over three to six months.

Jawline before and after photos are shown during your consultation at our Brentwood studio.

How Much Does Botox for Jowls Cost in Los Angeles?

Beauty Ranch prices neurotoxin by the unit, so your cost depends on how many techniques you need:

Treatment	Typical units	Beauty Ranch pricing
Botox	20-unit minimum	$15 per unit
Dysport	50-unit minimum	$5.25 per unit
Nefertiti technique (platysma)	20 to 50 units	Roughly $300 to $750 in Botox
DAO (corners of the mouth)	8 to 16 units total	Roughly $120 to $240 in Botox
Masseter	40 to 60 units total	Roughly $600 to $900 in Botox

Botox for jowls pricing at Beauty Ranch Medical Spa, Brentwood, Los Angeles. Unit counts are typical ranges; your exact plan and total are quoted at consultation. Prices subject to change; see our full pricing page.

For the tightening and volume treatments: XERF from $2,500, Ultherapy from $2,500, Sculptra $1,000 per vial, PDO threads $1,200, Kybella $600.

Book Your Jowl Consultation

Why Beauty Ranch for Jowl Treatment in Los Angeles

• A neurology-trained injector. Janee Malan, PA-C is a board-certified Physician Assistant whose career emphasis includes neurology, plastic surgery and medical aesthetics, with master class certifications for Botox. Lower-face Botox is a neuromuscular treatment, and few aesthetic injectors in Los Angeles bring a neurology background to it.
• Every option under one roof. Botox, XERF, Ultherapy, Sculptra, PDO threads and Kybella, so the recommendation is based on your anatomy, not on which single treatment a clinic happens to offer.
• Conservative by design. Janee's approach is natural but enhanced. You will not leave with a frozen smile.
• Nurse Jamie's protocols. Beauty Ranch is the medical spa of celebrity aesthetics nurse Jamie Sherrill, RN, and XERF is a signature treatment here.
• Brentwood, minutes from Santa Monica, Pacific Palisades, Beverly Hills and Westwood. 140 South Barrington Place.

Frequently Asked Questions About Jowls

Will Botox get rid of jowls?

Botox improves jowls that are caused by downward muscle pull, typically early to moderate jowls in the late 30s to early 50s. It relaxes the platysma and DAO muscles so the jawline sits higher. It does not tighten loose skin or replace lost volume; for those, XERF, Ultherapy or Sculptra are added.

Where do you inject Botox for jowls?

Along the jawline and into the platysma bands of the neck (the Nefertiti technique), into the depressor anguli oris at the corners of the mouth, and, if clenching is a factor, into the masseter muscles.

How much does Botox for sagging jowls cost?

At Beauty Ranch, Botox is $15 per unit and Dysport is $5.25 per unit. A Nefertiti treatment usually needs 20 to 50 units, DAO 8 to 16 units, and masseter 40 to 60 units, so most jowl plans land between a few hundred dollars and about $1,000 in neurotoxin. Your exact total is quoted at consultation.

What is the most effective treatment for sagging jowls?

It depends on the cause. For muscle-driven jowls, Botox. For skin laxity, XERF or Ultherapy. For volume loss, Sculptra. Most clients over 45 get the best result by combining Botox with a tightening treatment.

Does the Nefertiti technique help jowls?

Yes. By relaxing the platysma, the Nefertiti technique removes the downward pull on the jawline, which improves early jowls and softens neck bands. It is often the first step in a jowl plan.

How long does Botox for jowls last?

Three to four months. Results from XERF and Ultherapy build over three to six months and last a year or more.

Is there downtime?

None for Botox. XERF has no downtime. Ultherapy may cause mild redness for a few hours. PDO threads involve a few days of swelling.

Can Botox make jowls worse?

Incorrect placement or overdosing in the lower face can affect the smile or lip movement temporarily, and over-treating the masseter without addressing skin laxity can occasionally make jowls look more prominent. This is why the injector's understanding of lower-face anatomy matters. At Beauty Ranch, jowl treatments are planned by a Physician Assistant with a neurology background.

Who performs Botox for jowls at Beauty Ranch?

Janee Malan, PA-C, a board-certified Physician Assistant with a career emphasis in plastic surgery, medical aesthetics and neurology, master class certifications for Botox, and training with leading specialists in medical and aesthetic applications.

Where can I get jowl treatment near Brentwood or Santa Monica?

Beauty Ranch Medical Spa, 140 South Barrington Place, Brentwood, Los Angeles. Call (310) 587-3502 or book online.

Book a Jowl Consultation in Brentwood, Los Angeles

Bring your concern, and we will tell you honestly whether Botox alone will get you there or whether XERF, Ultherapy or Sculptra should be part of the plan. Beauty Ranch Medical Spa, 140 South Barrington Place, Brentwood. Monday through Saturday 9 to 5, Sunday 9 to 4. Call (310) 587-3502 or book online.

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Related reading:

• Masseter Botox in Los Angeles
• XERF Treatment in Los Angeles: The Complete Guide
• Ultherapy Cost in Los Angeles
• Sculptra and SkinVive in Los Angeles
• Skin Tightening in Los Angeles
• Ozempic Face: Skin Tightening After Weight Loss

Neck lines are a separate problem from jowls; here is how we treat tech neck lines.