Will Botox & jaw reduction make my upper cheeks look more prominent? I'm now 39 and had botox jaw reduction 18 months ago.

Question

While it slimmed my masseter muscle, it made my upper cheeks full , which meant I looked much younger. Now my masseter bulges are back and my cheeks seem deflated. I'm trying to figure out is whether my deflated cheeks are natural ageing changes (seems dramatic to see such a change in just a year) or if another round of masseter botox will help with deactivating the masseter and forcing the upper cheek muscles to work harder. Many thanks.

Nelson Lee Novick, MD · Answer

I have been injecting Botox for aesthetic purposes for twenty years and for masseter (lower jaw) reduction for nearly a decade, particularly in patients of Asian decent. In that time, I have not seen (nor have even read about) any secondary beneficial effects of this technique in enhancing or augmenting the cheeks.However, we are now fortunate to have two wonderful injectable volumizing agents, Radiesse and Voluma XC, that work well for nonsurgical cheek augmentation and typically achieve in about ten minutes gratifying results that last for approximately two years. I routinely use the latter two agents for creating higher cheekbones and improving light reflection and projection in my Upper East Side Manhattan office. In my Israel satellite facility, where a far greater number of regulatory agency approved fillers and volumizers are available, I prefer Emervel Volume and Stylage XXL for these purposes).

Jason Emer, MD · Answer

Masseter injections have no effect on the cheeks.  I do this treatment daily for many years now and have never seen a change in the masseter effect the cheeks.  Best, Dr. Emer.

Martin Jugenburg, MD · Answer

chewing is done by the masseter muscle and the temporalis muscle.  "upper cheek" muscles do not replace the masseter.

Parker A. Velargo, MD, FACS · Answer

Unfortunately, there are no "upper cheek muscles" of significance to recruit once the masseter muscle is Botoxed that can lift your cheeks back to their desired location.  If you had a great response to Botox the first time, I would go for the second treatment, wait a couple weeks, then go in for cheek augmentation with fillers.  Perlane, Radiesse, or Juvederm Voluma are great options for this area.  I feel only "core" injectors should perform cosmetic injectables (facial 
plastic surgeons, plastic surgeons, dermatologists, or occuloplastic 
surgeons).  This is because we all have a keen understanding of facial 
anatomy and the effects of injecting Botox/ Xeomin/ Dysport and fillers in different
 regions of the face.  Be sure you are seeing one of us, and I wish you well!

Jo Herzog, MD · Answer

I would try the Botox again and when those results are complete see whether you still feel that you need volume. If so, add a filler above.

Will Botox & jaw reduction make my upper cheeks look more prominent? I'm now 39 and had botox jaw reduction 18 months ago.

Answers (5)