Is everyone eligible for masseter reduction via Botox? And is it dangerous?

Question

Recently I've found out about botox being used to reduce the jaw. I have a very round face, and my jaw looks even square-ish from downwards angles. The first question I'd like to ask is: is everyone eligible for it? Does it slim down the face only on people with square jaws or will it work on round faces as well? While asking around I also discovered that local doctors insist that nobody should do it, because it's "dangerous". So is it really risky and how? What can I expect from this treatment?

Jason Emer, MD · Answer

I suggest posting photos, not everyone is a candidate although the majority of the time if you are not a candidate and botox is injected nothing bad realy occurs unless the botox goes to the wrong muscle. I suggest seeing an expert. Best, Dr. Emer.

Kevin Tehrani, MD, FACS · Answer

Thank you for the detailed question. Patients who are good candidates for Botox to the masseter are patients with strong jaw lines caused by a strong, hypertrophic masseter muscle. If you do not have a hypertrophic masseter muscle, then injecting Botox there will not do much to change the shape of your jaw line. I recommend seeing a board-certified plastic surgeon or expert injector in-person so they may evaluate your muscle in-action and decide what would be the best treatment plan to address your concerns. At our practice, we also provide consults via FaceTime or Skype for patients who live outside of NY. For more information, please visit our webpage.

Eric YK Li, MD · Answer

In patients who have a square-shaped face, different factors may contribute to increased lower facial width, including the shape of the jaw (mandible), the size of the muscle (masseter), and the volume of the soft tissues (parotid gland and fat).  An in-person assessment is required to evaluate which treatment option(s) are available in your particular case as well as what would be a reasonable outcome to expect.  Done properly by a trained physician knowlegeable in facial anatomy, Botox injected into the masseter is safe.  As always, seek proper consultation before treatment and best of luck!

Marina Plastic Surgery of Los Angeles · Answer

HI and thank you for your question! 
As stated, first step it getting evaluated by an experienced injector to determine if you are a good candidate and if this will help achieve the results you're looking for. 
We do a lot of Botox or Dysport to the jawline for facial slimming and it also helps with teeth/jaw grinding if that's is an issue. We have not seen any negative reactions to this area being injected, however, in the wrong hands anything can happen. Definitely recommended to go to a reputable office and injector. 
Best of luck, 
Jennifer Tinelli, NP-C

Sean W. Delaney, MD · Answer

Great
question. Both a prominent masseter muscle and overly large jaw bone (mandible) can
contribute to the appearance of a square jawline.  With qualified injectors, Botox treatment of the masseter muscle is very safe. While Botox is great for
slimming down the masseter muscle, it does not alter the underlying jaw bone. If the reason for a square jaw is an overly
large jawbone, treatment of the masseter with Botox alone may be
insufficient, and mandible reduction surgery may be necessary to make the
face slimmer. I suggest scheduling an in-person consultation with a facial
plastic surgeon to discuss the best treatment option to meet your
goals.

Leonard Grossman, MD · Answer

Botox being administered by a professional, it is always safe. You need to be evaluated in person by plastic surgeon or dermatologist to determine if your candidate for the procedure. good luck from New York City

Melvin Elson, MD · Answer

The injection of the masseter is to taper the face so that if your face is too thin it is not a good idea. it is extemely safe but be sure you choose a dermatologist who is experienced with the treatment

Alex Eshaghian, MD, PhD · Answer

Thank you for your question ana_stasi. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.Botox can be placed in the masseter muscle in the lower face to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.To assess for masseter hypertrophy I look at the patient and feel the masseter with and without biting down. If there is a significant bulge that becomes bigger with biting then the person is a candidate for such a treatment.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids as described above. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.Please consult with a doctor for specific recommendations. Good luck!

Mehdi Sina, MD · Answer

Hi,When the masseter muscle is large, it can add extra fullness to the lower third of the face. The muscle mass can be reduced with botox/dysport and that will slim the jawline. A careful exam of the muscle is necessary to determine of you would get a benefit from this treatment. When performed by an expert the risk of any unwanted effects are very low.Best,Mehdi Sina, MD

Is everyone eligible for masseter reduction via Botox? And is it dangerous?

Answers (9)

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