Am I a Good Canidate for Botox Masseter Reduction?

I was wondering if I am a good candidate for Botox Masseter reduction?  if Not, What Procedure is Good for my Problem Area? Please Help Me! For some reason my skin gathers more on the right side of my face along the jawline when I smile then the left side of my face. It doesn't matters how I smile or angle my head, Its still very noticeable. Not sure if its excessive skin, normal asymmetric, neck fat, face fat or sagging loose skin, Etc. What ever the problem, I would like opinions on how to treat it. Pictures are included to show a general area of my face.

Doctor Answers 10

Botox and Dysport for jaw slimming

Thank you for your question. I don't see any attached photos. 

Botox or Dysport can be a very effective way to contour the jaw line by reducing the masseter shadow through the outer jaw skin. In addition, it can reduce symptoms of jaw clenching or grinding of teeth at night time. This is an advanced technique that requires a strong understanding of the underlying anatomy. Some side effects can results in some very unintented effects. This can include affecting the smile due to diffusion of the Botox into neighboring smile muscles. Over treatment can also overweaken your jaw muscles making it harder to chew food and causes your jaw muscles to relax too much when you sleep.

The injection technique does vary by physical exam and the goals of the treatment. I ask my patients to place their hands along the sides of their face over their masseter muscles and clench on/off so they can feel the masseter muscles bouncing against their hands. I also ask them to repeat this at home in a couple weeks time to compare so they can see the effects of the masseter reduction.

Facial contouring goals may change the injection sites themselves to affect different portions of the masseter as well as the dose. The strength of the masseters can be felt by palpation and also helps me to determine dosing. In general, I start with 15- 25 units of Botox (OR 50-75 units of Dysport) per side for most patients. If they have very strong masseters, then I may increase the dose, but more commonly ask them to return in three weeks for a touch up. Once you get the desired result, I let patients know that future treatments may require less to maintain the look or the jaw clenching symptoms, especially if they get treated as soon as they notice the symptoms return. This can be as soon as three to four months, but in some cases, patients report that it lasts six months or more. I find it depends on the dose we use and how many times we have done the procedure as the duration may lengthen for patients that repeat it regularly.

Asymmetry of facial skin treated with many different devices such as Ultherapy, Fraxel, Pelleve, Fillers, Botox

Sorry but no photographs are included with your test. Please see a plastic surgeon or dermatologist to evaluate your face in person. Seeing your skin and muscle and fatty layers working together in different poses and with muscle contraction can help determine the best treatments for you. Botox, fillers, nonsurgical tightening procedures such as Pelleve, Thermage, Ultherapy, rejuvenation with volumization of deep fillers or fat injections, surgical lifting procedures, skin resurfacing procedures with lasers such as Fraxel or Portrait Plasma, etc.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 36 reviews

Botox for facial shaping

We do not have access to your photos currently.

However, your question is best addressed by an in person evaluation by one that may be able to offer good, viable options.  We suggest more than a couple of consultations.

Although Botox and Dysport work very well in reducing muscle mass and bulkiness for the Masseter muscle, it would not be appropriate to address what you are suggesting.  Sometimes a combination of dermal fillers with other modalities goes a long ways towards a tailored treatment plan.

A good  practitioner will be able to provide balanced information and honest feedback.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 8 reviews

BOTOX is very helpful when someone clinches their jaw

BOTOX is very helpful when someone clinches their jaw and they have a very pronounced masseter causing the face to look square.  By injecting BOTOX you can soften the angle of the mandible and jaw, but it doesn’t help loose skin.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.8 out of 5 stars 62 reviews

Skin gathering

What you see is the natural assymetry almost all individuals exhibit due to variations in muscle attachment, size and emotive tendencies. You absolutely should not do and kind of surgery as it is not indicated and you do not have any kind of disfigurement

Botox for Masseter reduction for loose facial skin

 I'm not certain your Masseter muscle is enlarged, on the right side because your hair is blocking view of that area of your face.  I do see the excess skin which by itself would not indicate anything more than excess skin.  Excess skin can be removed with various types of treatnments and procedures based on your goals.  You may want to have a couple of consultatioons with plastic and cosmetic surgeons.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

You Don't Need Anything


Please don't do anything with your beautiful face.  I certainly don't see any problem.  If you look at the one left oblique (semi profile) photo, you have the same smile line configuration on the left as on the right.  Many people feel like they have to have plastic surgery just because so many people do.  Please don't get caught up in the hype.  You are a beautiful and perfectly normal looking woman.


Botox for masseter reduction works

looking at the photos provided, I can't be certain that the fullness is secondary to masseter hypertrophy. Normally it's bilateral and due to grinding, chewing gum or some other jaw "exercise". unilateral fullness may be related to your parotid gland. You should see a physcian (ENT?) to make the diagnosis before settling on a treatment.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 1 review

Botox Can Help Shrink The Jawline

Jawline reduction by placing Botox into the masseter muscle works.  This procedure is popular in some Asian groups and there is not much harm from trying.  The botox is placed deep, but with very small needles.  The number of units required varies from 10-40 units per side, so it is useful to start small and see how much you like it.  The more units used, the higher the costs.

Very difficult to be accurate without an actual physical examination.


Masseter BOTOX will reduce the fullness of the lower outside of the face.  This may or may not make the chance your are looking for.  I think one issue you have is this seems to be an area that your body hold a little more fat.  When you put your chin down or smile this area bunches up.  Even a small reduction in body fat is likely to reduce the fullness of this area.  You can experiment with this by reducing your caloric intake about 10% for a couple of weeks.  If this does help, you can decided if you want to make long term changes in your diet to maintain this improved appearance.  Don't starve yourself to accomplish this however, small changes like eliminating salad dressing, reduced portion size, and limiting evening snacking are often helpful strategies.  This is even more effective when combined with prolonging your usual workout to increase the metabolic side of the equation.  If this is too successful, the face can actually be too thin, the opposite issue.  Because your issue is very subtle, I don't think you need to over do it.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.