My chin doesn't even look the same prior to masseter Botox, is my masseter regrowing or is this jowling? (Photos)

Question

Around February I had 20 units placed into each of my masseter. The first few months (April/May) the results were great and I was completely free of TMJ. However it is now September and I have completely lost the shape of my chin. Is my masseter regrowing or is this jowling. My chin does not even look the same prior to the treatment

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed explanation and timeline.

Masseter Botox is commonly used to slim the jawline and reduce symptoms of bruxism or TMJ, but changes in lower facial shape can sometimes raise new concerns.

Based on your description, here’s what may be happening:
1. Masseter Regrowth
Yes, the effects of Botox are temporary. By 4 to 6 months post-injection, the muscle typically starts to regain volume and strength.

If your facial shape started to return to baseline, this could reflect masseter muscle reactivation and gradual regrowth, especially if the muscle was quite prominent before.

TMJ symptoms returning is also a strong indicator that the muscle is beginning to function and grow again.

2. Jowling or Soft Tissue Descent
If the area appears heavier, with sagging around the jawline or under the chin, this could suggest early jowling.

Botox-induced volume loss in the masseter can sometimes unmask looseness in overlying soft tissue, particularly in individuals with minimal fat or thinner skin.

When support from the masseter is reduced, the facial fat pads and skin may shift slightly downward, contributing to a less defined or altered chin/jawline contour.

What’s most likely:
It could be a combination of both—partial masseter regrowth along with some degree of soft tissue laxity (early jowling), which is now more apparent as the original structure is changing.

Things to observe:
Firmness to touch: If you feel the muscle bulking back up when clenching, it suggests regrowth.

Soft or loose skin: Suggests descent of tissue more related to jowling.

While the changes are frustrating, they are not uncommon and often manageable with subtle adjustments, including addressing skin laxity or rebalancing volume elsewhere.

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. If your chin’s appearance has changed noticeably since receiving masseter Botox, it’s possible that what you’re seeing could be related to both the effects of the Botox and changes in facial structure. Masseter Botox is used to reduce the size of the masseter muscles, which can affect the overall contour of the lower face and chin. If the masseter muscles are shrinking, it might lead to changes in how the surrounding tissues, including the chin area, appear. Additionally, if there is a loss of muscle volume or tone, it might contribute to a more pronounced jowling effect or an altered chin profile. I hope this helps and best of luck!

Michael A. Persky, MD · Answer

Hello mm,
Your botox treatment has worn off and your massetter has returned to normal function.  Depending on the individual, Botox treatment of massetters is repeated every 3 to 6 months.  Good luck and be well.

Michael A. Persky, MD
Encino, CA

Camille Cash, MD · Answer

Botox effects are temporary, lasting approximately three to four months.  Since it has been about seven months from your treatment you are returning to your previous look and can return to your injector for another treatment.

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