One cheek is drooping down, will Botox help?

Question

I've noticed that the lower part of my left cheek is becoming heavier day by day. It has happened so only in the past 6 months or so. I don't clinch my teeth neither do I eat from one side of my mouth all the time. It used be better before but since the last six months, left side has become constantly heavier (right side in the pics). Will botox help? If yes, then how many units will I need? Plz help as it's making me depressed.

Thomas Wright, MD · Answer

I see from you pictures that both lower cheeks are a bit more prominent. I don't appreciate any difference between the left and right sides. But in your question you are saying the left feels heavier. There are many possibilities that can cause a heavier feeling in one cheek. They include sinus problems , Dental problems, injuries and infections. If this is the concern, I recommend consulting with an ENT or dental specialist.   To correct asymetric looks fillers are your best bet, and Botox wont really help.

Juan Carlos Fuentes, MD · Answer

Botox can work on lifting the brows by injecting the muscles that pull them down. In the corners of the mouth, there is a muscle that pulls them down (DAO) and Botox can be injected there to avoid the excessive action of this muscle on that area. Another muscle that may pull down the area along the jawline is the Platysma muscle, so Botox can be injected in that muscle to avoid too much pulling along the jawline. Other thing that can be use to improve the contour of the lower half of the face is Botox injected in the masseter muscle when this is too big. Some Botox will decrease the thickness of the muscle on that area, making the lower face look more slim. Fillers are also helpful to improve the contour of the cheek area, by filling some specific areas, you can get a little more cheek projection that can work as a lift. Please consult with an expert in this particular field, get a consultation in person to get an evaluation and the options for your case.

Toby Mayer, MD · Answer

No-botox won't help. See a very experienced surgeon who can discuss options since you do NOT WANT IT TO BE WORSE!

Kenneth D. Steinsapir, MD · Answer

I do think masseter botox would help your facial contour.  Generally the dose in in the 12 to 25 unit range.  Treatment seems to last about 6 to 12 months.  I would not recommend adding volume to the lower cheek especially with fillers that can't be erased.

Jason Emer, MD · Answer

A combination of treatments including fillers, lasers and radiofrequency tightening can help improve facial symmetry. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Jack Berdy, MD · Answer

The asymmetry is ever so slight in the pictures but clearly causes you some concern.  Mild asymmetry is not uncommon and may often be corrected with dermal fillers.  Botox relaxes muscles and will not give you the lifting effect that you desire.  You may get the desired lifting effect with the use of a filler like Voluma which when placed properly gives your cheek some structural support.  Make sure that whatever filler you use it should be an HA (hyaluronic acid) filler so it can be reversed if you are not happy with the results.  Just a word of caution when attempting to correct mild asymmetry you can create the appearance of a mirrored asymmetry where you are tempted to continually chase one side to match the other.  Good luck
  
Dr. Berdy

Steven F. Weiner, MD · Answer

A cheek can be elevated using fillers, not Botox. A filler with a high G prime, such as Restylane Lyft, is a great choice for improving this. I always use cannulas for this injection to minimize bruising risks and increased safety.

Johnson C. Lee, MD · Answer

Thank you for your photos. Facial asymmetry is completely natural and you may only just be noticing it for the past 6 months. There are a number of possibilities as to why this has become more noticeable including but not limited to changes in weight (gain or loss), genetics, natural aging, and even sleeping on the side of your face. Botox relaxes muscles so any Botox use will likely make your cheeks sag even more. You may benefit from having some filler placed in the cheek area to help lift your skin and give you a more a youthful and rejuvenated look. It is important to have it placed by an expert injector so that you have a natural and symmetric result. Hope this helps!Johnson C. Lee, MD Plastic Surgery

Shaun Patel, MD · Answer

The photos show that you have a facial asymmetry with less volume on the left side of the face then the right. Looking closely at the photos, your tear trough and nasolabial folds are also more prominent on the left side of your face because of the reduced left midface volume. A filler such as Voluma, Restylane Lyft, Radiesse or Sculptra could easily be used to correct this. I recommend seeing an experienced injector for best results.

Drew Varano, MD · Answer

Botox won't be of benefit . Botox is typically used for wrinkles in the upper face ( above the eyes) . It prevents wrinkles by paralyzingly the muscles but does not give the lower face a " lifting " effect . You are noticing early stages of skin laxity and skin tightening treatments such as Thermage , ultherapy are a few among other options available for skin tightening

One cheek is drooping down, will Botox help?

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