Cheeks still asymmetrical after Botox. Do I have other options? (photo)

Hello, hope you are well. I appreciate the asymmetry that you describe. In general, there are 3 things than can be contributing to your asymmetry: the masseter muscle, buccal fat, and facial skeletal asymmetry. An in-person exam is always the most informative to determine the relative importance of each, but based on the picture you have provided it appears that buccal fat may be the area to target for treatment (especially if masseter reduction was unsatisfactory). Buccal fat removal is a relatively straightforward procedure that can be performed under local anesthesia (transorally). The fat is extracted through the mouth and can be done asymmetrically if needed to achieve the best balance. In your case, may also help enhance your jawline and cheek bones for a less round, more sculpted appearance. Hope this helps!
Cheers,Dr. Tower

Thank you for your question and photo. You may benefit from combining your Botox injection with hyaluronic acid dermal fillers to create a more symmetrical appearance. These formulas can add volume to specific areas and balance your facial features. An autologous fat transfer is also a valuable option for adding volume and changing the overall face shape. Results from dermal filler injections can last for up to a year or more, while a facial fat transfer may last for much longer. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon or injector. They will be able to review your injection history, discuss your concerns with you, and help you decide on the best approach.

This is my expertise and a huge portion of my practice. Asymmetry is normal and expected. Buccal fat pad gives slimming not symmetry. Masseter botox will make you slimmer and make the jawline more loose. Fillers help give shaping and contouring. If you want perfect or close to perfect symmetry you need maxillofacial surgery or implants customized. I suggest seeing an expert to go through all options. Most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus8 or PiXel8 deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift. an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done. For facial slimming a combination of treatments are always needed. Options include: 1. Buccal fat pad removal to reduce fat on the lower face 2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping. 3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender 4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma. See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option. Best, Dr. Emer.