Would masseter Botox or buccal fat removal (or another suggestion) be best suited for me? (Photo)

You have beautiful facial features, but the width of your face at the mandibular angles prevents you from having a slimmer face. The buccal fat pads do not contribute to the mandibular width. Masseter muscle botox is helpful, but reducing the mandibular angles would provide a greater amount of mandibular narrowing. The procedure is performed in the office with sedation anesthesia.

In young patients with an enlarged lower face, several plastic surgery procedures can help achieve a more harmonious and balanced appearance. The cause of a heavy lower face could be either enlarged buccal fat pads, hypertrophic masseter muscles, or both. Enlarged buccal fat pads cause fullness in the anterior lower face, while hypertrophic masseter muscles cause fullness in the lower posterior face. To address each issue, different procedures are required. Buccal fat removal (bichectomía) targets the fullness of the lower anterior face, whereas treatments for the masseter muscles, such as Botox, address the fullness of the lower posterior face. Depending on the desired outcome, one or both procedures might be necessary.
However, it is important to know that if too much Botox is injected into the masseter muscles, the shape of the jaw could change, resulting in a more V-shaped facial appearance. This look is commonly achieved or requested by patients of Asian background, where a V-shaped face is considered very attractive. In contrast, for Caucasians, this could alter the desired square jaw appearance, which is often considered attractive. Therefore, careful consideration and expertise are essential when performing these procedures to ensure the desired aesthetic outcome is achieved.
I hope this helps!
Sincerely,
John Mesa, MDBuccal Fat Removal Specialist Plastic SurgeonNew York - New Jersey - Miami.

Thank you for your question and sharing your photographs. My impression is that Masseter Botox would be the best place to start. It is a reversible procedure and is more likely to create the impression of a V-shape contour of the face. It needs to be carried out with repeat check of the extent of the muscle towards the front by clenching and relaxing the teeth, because the front fibers of the muscle contribute some of the elements of squareness to the lower face. If when you do this you feel that you have achieved your targets, then buccal fat reduction is not necessary.

If you feel that there is still something you want to achieve in terms of definition for the jawline, then buccal fat reduction may contribute. It is not particularly easy to analyze the characteristics of the buccal fat in a person that is smiling, because of its displacement by the activity of the muscles of the face. The assessment for the buccal fat is best carried out when relaxed.

I would recommend seeing an American Board of Plastic Surgery certified plastic surgeon with experience in facial surgery. It is hard to provide any recommendation with this poor quality photo that does not show the entire face.

Hi VirgoRising113

Based on the goal in your morphed photo, reducing the size of your masseter muscles with Dysport or Botox (or equivalent neuromodulator) you will be able to see a significant reduction in volume of the sides of your jaw along the angles of your mandible, and a slimmer more tapered appearance like your simulated image. Like other muscles in the body it will take time for the masseter muscle to shrink down in size (typically 4-6 weeks after the first injection to notice a change), and serial treatments (once every 4-6 months) will create the most significant amount of slimming.

Hello, hope you are well. Thanks for posting these photos, and a great question. Buccal fat removal will not reduce the width of your jaw and lower face. As you suggested, masseter Botox is a great way to start because it is minimally invasive and relatively low cost. However, it does not result in a permanent change. Jaw contouring is a straightforward procedure to permanently reduce the width of the jaw and create the desired result shown in your photos. This is done by shaving down some of the excess width of the jaw bone (especially near the angles of the mandible) from inside the mouth. Hope this helps!

Best,
Dr. Tower