Would Botox in the masseter muscles, a mouth splint, or Invisalign help contour my face?

Question

I have a long history of bad mouth habits, and not seeking treatment for TMJ issues. Some of my facial fullness is genetic (obviously), but I feel that the widened appearance in the jaw area is due to clenching and crowded teeth. In this photo, I weigh about 160 pounds, and I plan to lose about 40. What combination of therapies would help make my face appear more feminine and less widened at the jaw area? Thank you!

Donald B. Yoo, MD, FACS · Answer

Botox for masseter reduction will certainly reduce the fullness along the angles of your mandible - where the masseter muscle attaches to your jaw.  A typical starting dose for Botox is 25 units on each side.  The most significant slimming effect will be experienced in the first month, and will continue for 3-4 months while the Botox is active.

Jason Emer, MD · Answer

There are many options for contouring and a proper in person consultation is needed to discuss your goals.  Best, Dr. Emer.

Nelson Lee Novick, MD · Answer

A muscle relaxing agent, such as Botox, Dysport, or Xeomin can work well for reducing hypertrophic masseter muscles, which may well be a significant contributor to your problem as a result of the repeated and habitual clenching that you describe.That having been said, since you plan to lose a significant amount of weight, it would be wise to hold off on any intervention until you have achieved your weight loss goal--at which point it will be easier to determine how best to proceed. It is even possible, at that point, that you may decide that you do not even need to proceed with any treatments, and even should you decide to have treatment, the amount of material needed may be less.  Wishing you much success going forward.

Shaun Patel, MD · Answer

Great question. Combination treatment with Botox injection into the masseter muscles and filler injection to the mid face using Voluma, Restylane Lyft, or Radiesse usually results in a slimmer facial profile. In appropriate patients, Kybella could be added to the submental (under chin) area to help with lower face contouring. Your photos demonstrate prominence along the posterior aspect of the jawline which I suspect is related to the masseter. I cannot comment on Invisaline or a mouth splint as I am not a dentist. However, I do believe Botox would be beneficial. I recommend that you see an experienced injector for an in-person consultation.

Alex Eshaghian, MD, PhD · Answer

Thank you for your question SerenaHeart. Botox is a purified protein used to address wrinkles associated with facial expression. It can be placed in the masseter muscle in the lower face to help improve a square jaw. If a patient of mine is planning to lose weight I recommend to them that they return for cosmetic treatments once the desired amount of weight is lost. This is so the face can be assessed at that time, when changes are seen. Please consult with a doctor for specific recommendations. Good luck!

Millicent Odunze Geers, MD, MPH · Answer

If you truly are going to lose 40 pounds, as you've mentioned, that's the most effective and natural contouring you'll ever get. Invisalign is not going to affect major changes in the shape of your face, but in the alignment of your teeth, so that's a totally separate issue. The dental splint will help you to stop grinding or clenching and eventually will help to decrease your masseter size or at least keep it from increasing in size.  A decrease in masseter size can be enhanced with the use of Botox. But none of the medical interventions you've mentioned will have the effect of a 40-pound weight loss. You may want to try that first. Will be less expensive and you won't have to keep going back for repeat Botox injections.

Erik Suh, MD · Answer

Yes, botox is commonly used to slim down the jaw muscles. You can expect about 10% reduction using 20 units on each side to 20 % reduction using 30 units on each side for most patients.    Remember though, bigger the jaw muscles, more reduction you will have.

Would Botox in the masseter muscles, a mouth splint, or Invisalign help contour my face?

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