How Can I Tell if I Need Botox in my Masseter Muscle?

Hi, I have a very large jaw and was thinking of having it reduced by Botox in my masseter muscle. How do I know if this will be successful for me, ie if my large jaw is caused by my masseter muscle and not just my jawbone...? Thanks for your help!

Doctor Answers 10

Botox for hypertrophic masseter muscle of a wide face vs. bone enlargement

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Muscle hypertrophy vs. jawbone enlargement is different in shape.  The jawbone enlargement, often is from front to back not side to side, but if you are still wondering if it is the bone structure, then check the position of the widening.  lower cheek widening is jawbone, and masseter muscle enlargment or hypertrophy is mid cheek.  in the olden days, mid cheek buccal fat pads were removed by plastic surgeons to help create a better defined cheekbone but this can lead to an appearance of premature aging as thin cheeks indicate illness, tiredness, and fatigue.

Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Try clenching your jaw muscles with your hand on the side of your jaw line

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Try clenching your jaw muscles, with your hand on the side of your jaw line - almost in the middle.  Feel around until you feel movement when you clench down on your teeth.  If you feel the muscles move a lot when you clench and un-clench, then Botox to the masseters will most likely help.  If you are the right candidate, then a little Botox is an easy treatment that can lead to a tremendous benefit.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Botox to decrease a large jaw.

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The best way to deside if Botox injections would decrease the size of your jaw is to have a consult, or two, with surgeons who will evaluate the size of your Masseter muscle, since this is what the Botox would be reducing.  Botox injections are light years easier and less invasive than bone surgery alternatives and IMHO a great way to start.  Try it and see if it works.  This, of course, if you do in fact have an overly prominent jawline...which should be evaluated during consultation as well.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Can Botox Help Reduce the Size of my Jaw?

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Hi Catya.  A proper evaluation by an experienced injector should be able to tell you if you are a candidate for this procedure.

The results will depend on what extent your jaw shape is based on bone structure or muscle structure.  If you have a very strong and thick masseter (jaw) muscle, then there is a good possibility you will respond well.  We set the expectation that results will develop slowly over the course of a year with 3-4 injection visits.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

How to tell if Botox is needed to reduce masseter muscle size

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You need to be evaluated by a board-certified dermatologist or a plastic surgeon to determine if the shape of the jawline comes from the muscle or bone.  If it is muscle, and you feel you want the jawline more narrow, Botox can be injected into the masseter.  It takes 3-4 months to see results after injections, but Botox can reduce the size of the muscle.

This needs to be done by a doctor with training and experience in performing this procedure.

Emily Altman, MD
Short Hills Dermatologic Surgeon

Clench your jaw, while resting your fingers on the side of your cheek, below the level of the ear

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If you feel a bulky mass when you clench, that is your masseter!  Botox can slim down that bulk.  

Botox and Dysport for jaw slimming

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Thank you for your question. 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. 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.

Consultation with Medical Injector

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This can be determined by meeting with your experienced medical injector and having a physical examination of the area. 

First you have to decide if you have a problem that you would like corrected...

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just because the masseter is enlarged doesn't necessarily mean it needs have to perceive there's something not quite right that you would like improved...if its your masseter - you'll have a relatively square jaw with prominence of the sides of your cheek in front of your ear and above the jawline...and when you bite down this area will get larger...and of course for a more angular face, nothing beats botox...

Ken Landow, MD
Las Vegas Dermatologist

Botox Can Be Used to Reduce the Size of Facial Muscles

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You would need to be evaluated by an experienced physician to determine if Botox would be a successful treatment for you. Over the years, Botox has taken on many new uses that are quite controversial. Botox has been used to shrink certain facial muscles (masseter muscles) to change the hard, angular shape of the jaw line. Also, in certain cultures, Botox has been used to decrease the size of the calf muscles to give a “more feminine” appearance. Using a neurotoxin such as Botox to weaken muscles that are necessary for everyday use seems crazy to me.


Mitchell Schwartz, MD
South Burlington Dermatologic Surgeon
4.7 out of 5 stars 12 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.