I Had Jaw Reduction Botox 2 and a Half Months Ago but Now my Jaw is the Same and my Cheeks Have Really Sunken In. What Happened?

I had botox for jaw reduction 2 and a half moths ago. I really hate the results. The jaw is the same but my cheeks have sunken in and I feel that the skin around my mouth area has sagged as if there is no muscle to support it and it feels 'heavy'. What do you think went wrong? Is it possible he injected the botox in the wrong muscle? Thank you

Doctor Answers 6

Botox to masseter

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You will get slight sagging from botox to the masseter if you are over age 40 or so and the botox dose was high. Also, if the injection is close to the cheekbone area (as opposed to down low along the bottom of the jaw angle) you will get more hollowing.

Beverly Hills Plastic Surgeon
4.5 out of 5 stars 79 reviews

Keys to Using BOTOX® Injections for Jaw Reduction

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From your description, it sounds very possible that either one of two things went wrong:

  1. BOTOX® has migrated into the wrong area, or
  2. BOTOX® was injected into the wrong area.

When used for jaw reduction, BOTOX® is most commonly injected into the masseter muscle at the angle of your jaw, just below your ear. This causes decreased function of only the most superficial portion of this muscle, with secondary shrinkage of the muscle from lack of use.

The deeper levels of this muscle retain their function so that chewing is either normal or only slightly diminished. There should be no sagging or decreased movement around the mouth as you are experiencing.

I recommend that you return to your injector and express your concerns and dissatisfaction with your treatment, enabling him/her the opportunity to rectify the situation.

Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 18 reviews

Botox and jaw reduction

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What you are describing is unusual but might be that the Botox affected the surrounding muscles enough to weaken them and allow less robust support of the tissues, thereby allowing them to sag. As the Botox wears off, that effect should reverse itself though.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

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Jaw reduction with botox?

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Botox can be used for masseter hypertrophy which make shte jaw look larger. However, this requires multiple treatments for the muscle to atrophy. It doesn't just happen over night.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Had Jaw Reduction Botox 2 and a Half Months Ago but Now my Jaw is the Same and my Cheeks Have Really Sunken In

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Without an examination much less a photograph it is impossible to answer your question with anything resembling precision. Botox paralyzes the muscle it is placed in. If the intent was to make the chewing, Masseter, muscle less prominent, it APPEARS that attempt failed and instead the Botox MAY have weakened the muscles responsible for lifting the corners of the mouth paralyzing them ("skin around my mouth area has sagged as if there is no muscle to support it and it feels 'heavy' ").  Unfortunately, this effect will last close to 4 months but you should be able to regain function in the area.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Jaw Reduction with Botox

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As panel members suggested, it's difficult to provide feedback without viewing photos.  We would encourage you to discuss your concerns with your injector so that he may provide more thorough information as well as treatment options.

Most patients that undergo this treatment find the results very satisfying.  However, dosing and technique are important as is with each procedure with Botox.

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