How to improve chin, could masseter Botox improve divots? (Photos)

Question

Had filler placed in ''divots" but believe it only made issue worse. Could masseter botox improve divots and lines while smiling? What else could help?

Joelle Lieman, MD · Answer

Your photos are helpful to see your masseters. I would be careful of treating only the TMJ since it could cause less structure in the lower face. If the TMJ causes you pain, I would treat it, but consider a filler/hylaronic acid to fill in the "sulcus" or area around chin. Hope this helped.

Dean P. Kane, MD, FACS · Answer

Dear nuturenoon,

Thanks for sharing your photos. They show your concerns. The passive and active changes as we age are causing a deepening of the lower cheek trough. These are parallel to and not the marionette crease. With the loss in restoration of collagen as we age, the skin loses resistance to creasing / folding and the subcutaneous (under-the-skin) fat and tissues sag. This appears to exaggerate the “divots” or hollows you notice; it also makes the appearance of your masseters to be wider or enlarged. Masseter botox will help soften the width at the jaw but also diminish volume allowing the skin to relax further. Consider:
1.	Consult with a talented and artfully skilled Board Certified Plastic Surgeon.
2.	Upper cheek volume fillers to carry the tissues upwardly
3.	
4.	I do like your idea of masseter botox to soften the width
5.	Consult with a talented and artfully skilled Board Certified Plastic Surgeon.
6.	Injectables to soften the folds directly.
7.	Zein Obagi Certified ZO Skin Health to stimulate collagen overall skin rejuvenation
8.	Sculptra skin tightening  
9.	PDO Thread “facelift” to assist lifting the jawline and cheek laxity
I hope this helps. Happy holidays. All the best!

Leonard Grossman, MD · Answer

The reason you have the shape and the movement of your face the way you do is because these are your genetics and skeletal as well as muscular make up of the face. You could use some Botox in your masseter muscles in order to make this, possibly less noticeable, however, your face may become too narrow for the proper proportions with respect to the upper face. Again the good thing is, Botox will wear off and you’ll know one way or the other, if this is the right thing for you. I hope this helps and good luck from New York City Plastic Surgery.

How to improve chin, could masseter Botox improve divots? (Photos)

Answers (3)

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