Botox in the masseters gave me jowls. What can I do? (photos)

Hi Joengland, So sorry about what happened. In general, I worry about my patients over 35-40 who get botox or other neurotoxin to the masseter muscles for grinding of the teeth (Bruxism.) It will help with the grinding, but may result in a secondary side effect of jowling if the dose is too high, or even just right to treat the grinding may cause this to happen. Luckily the masseter muscle can rehypertrophy meaning it can grow and fill out replenishing the volume to the jaw angle area.
Some patients may request a jaw angle filling using hyaluronic acid like Restylane or Juvederm to build back the jaw angle volume, but I advise them to wait if they do not plan to do botox in the future. If the like the botox effect for the bruxism, and potentially some headache triggers prevention, then they may want to do the botox again. If this is the case, I would inject the Restylane or Juvederm, under the SMAS, and over the atrophied masseter to recreate the volume lost.
Be careful about allowing your weight to change if you are depressed about the situation. In your before photo, your under chin area did not look as full. Simply shrinking the masseter with botox should not create too much of a double chin, so just be careful with your weight, especially if this is causing you a lot of stress. We don't want the one problem to compound into other problems.
Please don't compound your problems with additional procedures before the botox effect has fully worn off. Kybella to the jowls can cause a temporary weakness/paralysis to the marginal mandibular branch of the facial nerve that can run around the jowl area. Since Kybella can dissolve fat, the insulation around nerves is also made of fat, so be careful with advice you get from the internet.
Hope you found my comments helpful. Best, Dr. Yang

I'm sorry you are unhappy with your masseter Botox treatment. The effects from Botox will wear off gradually over the next three to four months and you should return to your pre treatment appearance. You can also consider fillers for facial contouring if you like the other effects from the Botox and would like to repeat the treatment.

Hello and thank you for your question. We would always recommend a face to face consult however in this case the best option would be to let the botox wear off 4-6months and reassess. You could have treatment before then but your face will change again as there toxin wears off so better waiting then before treating.
We hope that answers your question. Best wishes