There’s no denying that Gen Z continues to become more and more interested in cosmetic treatments. According to the American Academy of Facial and Plastic and Reconstructive Surgery’s 2022 report, 75% of plastic surgeons reported an increase in patients under the age of 30. Neurotoxin injections, in particular, are incredibly popular among this group, including those performed in the masseter, or jaw. (A recent search revealed that “masseter Botox” videos on TikTok have more than 122 million views.) Injecting this area offers a rare combination of aesthetic and functional benefits—but are there drawbacks? Increased popularity of masseter Botox has also led to more talk about its potential long-term effects—namely, whether it can lead to lower-face jowling. So we asked doctors to weigh in on the internet debate, and here’s what they had to say.
What is masseter Botox?
It’s the use of neurotoxin injections in the masseter, colloquially known as the jaw muscle. Just as it does anywhere else, the neurotoxin inhibits the activity of the muscle, which, in this case, has two different effects. From a functional perspective, it’s great for people who have TMJ or who grind their teeth, as it’s very effective for addressing symptoms such as jaw pain and soreness, says Dr. Babak Azizzadeh, a board-certified facial plastic surgeon in Beverly Hills, California. From an aesthetics standpoint, it reshapes the lower face. “By weakening the muscle, you essentially shrink it down and flatten it, which is why this is so good for narrowing this area and creating a more tapered jawline,” he explains.
@jahszminn_4 Masster botox for TMJ disorder but comes with a nice side effect of slimming the face lol #masseterbotox #masseterbotoxbeforeandafter ♬ original sound – jahszminn_
@aestheticsbydranj Absolutely LOVE this treatment in the right patient! More examples on my ig/website #jawlineslimminglondon #jawslimminglondon #masseterbotox #masseterbotoxlondon #aestheticdoctor #jawbotoxresults #aestheticdoctorlondon #jawbotoxlondon ♬ original sound – Dr Anjuli Patel
Can masseter Botox cause jowls?
There’s a theoretical concern here: if the underlying muscle shrinks, then the overlying skin will have less support and can start to droop. What makes sense in theory doesn’t translate in real life. All the doctors we spoke with agreed that there’s absolutely no evidence nor is there a reason that masseter Botox injections—even those performed repeatedly, over time—will lead to jowling. Why? For starters, we’re talking about slightly different areas of the face. “The masseter muscle is a lot more posterior than where jowling occurs. It’s located closer to the ear, whereas jowling shows up in front of that,” explains Dr. Hardak Doshi, a board-certified facial plastic surgeon in New York City. “Jowling is an intrinsic part of aging that occurs due to poor skin quality and elasticity, not from repeated masseter Botox injections.” Dr. Azizzadeh adds that changes in bone structure coupled with a dropping of the buccal fat pad (both of which happen naturally as we age) further contribute to the appearance of excess fullness—or jowls—right behind the chin.
Yes, it is possible that the skin could start to look more loose around the jawline if the underlying masseter is slimmed out, says New York City board-certified plastic surgeon Dr. Mark Albert. The big caveat? “Most people have enough elasticity to the skin that it can contract and conform to the changes the Botox is making,” he explains. Plus while the Botox does change the anatomy of the muscle, it’s really not to a degree that’s significant enough to drastically stretch out the skin, adds Dr. Azizzadeh.
@drsamanthaellis #botox #masseterbotox #facialtreatment #cosmeticdermatology #dermatologist #dermatology #dysport #tmjdisorder #tmjtreatment #teethgrinding #jowls #jawline #botoxtreatment #skinexpert ♬ Pieces (Solo Piano Version) – Danilo Stankovic
All that being said, if someone already has some jowling, masseter Botox can exacerbate the appearance of sagging skin in this area, says Dr. Albert. Similarly, those who are older and who have poorer skin quality to begin with may be more likely to experience this. However, given that it tends to be younger patients who are getting masseter Botox injections, this is really not a concern, he points out.
Not everyone is a good candidate for masseter Botox
What’s more important to consider is whether this treatment is right for you. “Not everyone who has a wide face is a good candidate for masseter injections. It’s not always a big muscle that’s the culprit. Things such as the jawbone, fat, thickness of the skin, and even size of the parotid gland can all play a role,” explains Dr. Doshi. “Injecting Botox into the masseters of someone who doesn’t need it can certainly create an optical illusion of jowling,” says Dr. Azizzadeh. The good news? While Botox in the masseter does tend to last a little bit longer than elsewhere on the face—about six months as compared to three or four, according to the experts we spoke with, thanks to the fact that both a greater quantity is used and the masseter muscle behaves slightly differently)—it’s still not permanent. Any changes you do notice will self-resolve as the Botox wears off, Dr. Albert says.
