Will Botox in my masseters make my already long face appear even longer? (photo)

Question

Im thinking of getting botox in my masseteers cause of TMJ. The thing is, I have really long face and big chin (unfortunately) and I am scared that botox in the massateers will make my face appear even slimmer and longer and therefore my prominent chin will look even bigger. Also Im concerned it will overall make me look older. I have uploaded a picture of my lower face. What do you think? Thanks in advance for answering! :)

Nelson Lee Novick, MD · Answer

When Botox is used for shrinking hypertrophied (enlarged ) masseter muscles, a procedure much sought after often for purely aesthetic reasons by many Asian women for tapering the lower face, the results are typically quite gratifying. However, when used for TMJ, especially in Caucasian faces, there is a real concern for creating the kind of laxity you describe. The good news is that an appropriately selected, robust volumizing filler, such as Voluma XC or Neauvia Intense Flux, injected after the masseter treatment into that region can help to retaper the lower face and redefine the jawline. In experienced hands, this should take no more than about ten minutes to perform. So, vis-a-vis the Botox for the TMJ, if you need it, have it done, and then, if necessary, that treatment can be followed by the injectable volumizer. Best of luck to you.

Jason Emer, MD · Answer

botox Is good for facial slimming but often can make the face look a litlte saggy after, so if you do this consider fillers, threads, or morpheus long term to keep you skin and contour in check.  Also do at home dermarolling daily (see link to emeragecosmetics.com for our at home dermarolling protocol).  Best, Dr. Emer.

Tanveer Janjua, MD · Answer

It is ok to go ahead. The atrophy of masseters can be compensated with fillers. You might not even see a big change in the size of masseters. Also think of Kenalog in TMJ, works great if you have TMJ pain. Watch the video below. RegardsDr. J

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  Nothing replaces an in-person examination but it doesn't appear that you have significant masseter hypertrophy so I do not think that treatment will result in a significant change to your facial proportions.  Hope this helps.

Kevin Tehrani, MD, FACS · Answer

Thank you for your very smart question and posting an appropriate picture. You’re correct to note that making your masseter muscle smaller will not benefit your facial harmony. Botox injections for TMJ don’t necessarily have to be done in the masseter, in fact best done in the Pterygoid muscle inside the mouth which won’t change your facial anatomy at all.  Please look for an advance injector to provide this small dose of Botox for you.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question and helpful photo. I think the benefit of reducing your TMJ symptoms would be worth trying Botox in the masseters.  Your dermatologist can start with a conservative amount and titrate up every visit if you need more to relieve the pressure on your teeth.  If it is done carefully, the right amount of Botox will not make the lower face sag noticeably.  I just wouldn't do a maximum amount the first time.  I would start with somewhere between 10-15U per side, although some of my patients have such strong muscles we end up injecting 30U on each side.  The procedure does not need to be done often, sometimes just one or two treatments is enough for long lasting benefits.  Please see an expert and best of luck!

Douglas Taranow, DO, FACOS · Answer

You have a very nice and narrow face.  Botox for the TMJ is very effective.  It will not make your face appear longer, but it may thin the back/bottom of the jaw where the masseter muscle is.  You may be able to start with a lower dose to see if it aids in reducing your TMJ issues.  If so, the thinning effect will be minimal

Leonard Grossman, MD · Answer

Botox can be an excellent treatment option for patients suffering from TMJ. In your case it's not going to make your face appear longer but it will make the lower portion of the face even narrower. There are other means of treating TMJ without any injections or surgery. You can give our office a call and ask for me personally and I will explain everything to you over the phone, It will not require an office visit. Good luck from New York City plastic surgery

Reuel Aspacio, MD, FAAD - Account Suspended · Answer

Hi there,I think with your facial structure that thinning result would be minimal.  Give it a try and see if it indeed does help your TMJ.  Best of luck...

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