Masseter botox and Voluma cheek filler. How did my face end up worse? (Photo)

It’s understandable to feel frustrated when cosmetic treatments don’t deliver the outcome you expected. Here’s what may be contributing to your concerns:
1. Masseter Botox Effect
Masseter Botox reduces the bulk of the jaw muscles over time. In some individuals, especially those with naturally lean faces, this can create a hollowed or sunken look in the lower face as volume decreases. It typically takes a few weeks to see the full slimming effect, which may accentuate asymmetry if facial volume is already imbalanced.
2. Cheek Filler Placement
With only 0.7 mL total used for both cheeks, the volume may have been too subtle to achieve noticeable lift or balance. If the filler wasn't evenly placed or if your natural facial structure is asymmetric, it could emphasize differences rather than correct them.
3. Lip Flip Contribution
While unrelated to the cheek or jaw, a lip flip can subtly change facial proportions and draw attention to other areas—especially if the lower face is undergoing structural change from Botox and filler.
What You Can Do
Reevaluation by your injector is key. A touch-up or adjustment (e.g., adding more volume to the deficient side or dissolving uneven filler) may help restore symmetry.Masseter Botox wears off gradually over months, so its effects aren’t permanent.If the hollowness persists, strategic filler placement or skin-tightening treatments may help restore balance.
A conservative and customized plan going forward can help you feel more confident in your results.

It's difficult to pinpoint exactly what has changed based on your before and after photos, however, if some of the neurotoxin was injected into your resorious muscle, that can cause a subtle change in the appearance of your facial shape, especially with smiling. The effects of Botox will completely wear off. I hope this helps. Sincerely, Dr Joseph

Hello,
This is Dr. Hong from Fresh Clinic (Seoul).
What you're noticing is a result of the masseter Botox treatment. While Botox can be effective for some individuals, in your case, it has caused a temporary loss of jawline support due to the relaxation of the masseter muscle. It's important to allow the muscle time to heal naturally. Typically, after about six months, the Botox effects will subside, and the muscle tone should gradually return.
I also recommend avoiding additional treatments, such as fillers or Sculptra, for volume restoration at this time. The best approach is to refrain from further injections for a while to give your muscles time to recover.
If, after several months, you do not see noticeable improvements, options like liposuction to reduce bulkiness in the lower part of the face, along with some lifting treatments, could help to address the issue.
Best regards,Dr. Hong