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Hello,From your photo it looks like you would be a great candidate for buccal fat pad removal, which is a procedure that can be done under local anesthesia. Masseter Botox can also make an improvement but will need to be done periodically. When you clench your teeth your masseter muscle will contract and you may feel your muscle bulge. Overall, both are great options for your concerns and require no general anesthesia. Best of luck,Dr. Luck
