Jaw Asymmetry - could Botox help or will surgery be needed? (Photos)

Question

Considering a plastic surgery consult for my facial asymmetry, mainly my right jaw. I have a consult with TMJ specialist, as I am wondering if that’s my issue. This masseter muscle feels big and from the 3/4 view on my right side you can see contour is rounder and lower than left side. At other angles it looks worse. Could Botox help w/this? Or is surgery needed to correct? Any other suggestions/other surgery. Low confidence for years, and I’m just tired of feeling this way.

Anna Chacon, MD, FAAD · Answer

Hi,

I completely understand how frustrating and discouraging facial asymmetry can feel—it’s natural to want a solution that restores balance and confidence. From what you’ve described and based on the photo, it sounds like your right masseter muscle is more prominent, which can create the appearance of a rounder, lower jaw on that side.

Botox can be very effective if the asymmetry is mainly due to muscle hypertrophy (an enlarged masseter). By relaxing the muscle, Botox can gradually reduce its size over a few months, softening the jawline and improving symmetry. This approach is non-surgical, temporary, and works best when the bone structure is relatively even.

However, if there is underlying bone asymmetry or structural differences, Botox alone won’t correct the contour completely, and surgical options like jaw reshaping or genioplasty may be considered. Often, a combination of treatments—careful Botox placement and, in select cases, minor surgical adjustments—can give the best results.

Since you’re also seeing a TMJ specialist, that’s an excellent step, as jaw function and muscle tension can play a big role in appearance and asymmetry. Other non-surgical options might include masseter-targeted physical therapy or facial contouring treatments, but the main effect for your concern would likely come from Botox if the asymmetry is muscle-driven.

I know this has affected your confidence for years, and it’s completely valid to want a solution. With careful evaluation, you can usually find a path that improves both function and appearance.

Camille Cash, MD · Answer

If you have a hypertrophied (overgrown) masseter muscle then Botox could certainly help bring your facial contours into better balance.  The treatment is done in the office with results seen after a few weeks.  The effect is temporary, but treatment can be repeated as needed to maintain the desired result.

Jaw Asymmetry - could Botox help or will surgery be needed? (Photos)

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