Would I get better results from buccal fat removal or masseter Botox? I want to achieve a more balanced look. (photos)

Question

Dear doctor, I have noticed the lower half of my face has increased in volume. I am not sure if it’s because of fat gain or increase in muscle size. I am 23 years old. The first picture is from 2017 and the second picture is from this year. I want to decrease the volume of my jowls/jawline to achieve more balance in my face. Based on the pictures would I be a good candidate for buccal fat removal or could I also give masseter botox a try? Thanks in advance. Kind regards, Diana

Caner Kacmaz, MD · Answer

Thank you for your question. Buccal fat removal is a procedure that creates the appearance of higher cheekbones, a more defined jawline, and a slimmer face. It contours your face into a slimmer and streamlined version. I believe you are a good candidate for a buccal fat removal procedure. Thank you and best wishes.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. Since you’re considering both buccal fat removal and Botox injections, I would suggest giving Botox a try first to see how you like the results. When injected into the masseter muscle, its size is reduced to provide a slimming effect to the lower third portion of the face. Results from Botox generally last 3-4 months, at which time you can decide whether or not this is a satisfactory option for you. 
If you find that you want a further, permanent slimming effect, buccal fat removal can reduce fullness in the area between the cheek and jawline to create a more defined and contoured appearance. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector who can suggest the best option for you.

Jason Emer, MD · Answer

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.

David Hatton, ND · Answer

Hi Dianab1111,To better determine which procedure would be most beneficial, try these two actions. First clench your jaw tight and see how much your masseter muscles become visible. If they extend out, botox could help. Relax the muscles and then slightly suck in your cheeks. This action will help to give you an idea of what a buccal fat pad removal would look like. To get a better idea, book in with a plastic surgeon in your area for a consult so they can review it in person. Hope this helps.

Camille Cash, MD · Answer

I recommend trying the masseter Botox first.  It will reduce the size of the masseter muscles resulting in a slimmer appearing jawline.  The treatment is done in the office with final results seen after two weeks.  The effects of the treatment will fade gradually over three to four months.

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!Masseter botox injection will reduce masseter muscle volume, making the face look slimmer and more V-shaped. The effect lasts for 3-4 months or so, requiring maintenance injections. Buccal fat excision is invasive and irreversible...I would try the less invasive option.Best wishes...

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