Can I Slim a Square Face with Botox? (photo)

Is my square face due to masseter muscles or am I born with a square jaw line? I have been to 2 clinics, they both do not do surgery, just non-surgical procedures. I am dubious as to these clinics telling me that it is indeed my masseter muscles and botox will slim my face as, well they would say that as they don't do surgery!! On 1st pic you can see my square jaw, with my left side noticeable larger than my right. I've attached profile pics of my right and left side also. Thank you in advance

Doctor Answers 15

Botox for Masseter (Jaw) Reduction

Hi Mittenz.  You are an excellent candidate for masseter reduction using Botox (Dysport).  We have had good outcomes with this procedure in as little as 1 treatment, but let patients know they will need to do it 2-3 times per year to keep up.  We use either 25 units of Botox or 75 units of Dysport on each side during the procedure.  You can click through on the link below to see results.

Los Angeles Facial Plastic Surgeon
4.3 out of 5 stars 6 reviews

Masseter muscle hypertrophy

I have had good success with botox injections of the masseter muscle ,mainly in patients with asymmetry. The trick is to leave enough muscle for mastication and yet reduce muscle mass. Surgery for this problem is difficult as a lot of bone has to be removed to see a decrease in the overlying soft tissue.

Terry A. Cromwell, MD (retired)
Lafayette Plastic Surgeon
5.0 out of 5 stars 2 reviews

Masseter muscle reduction with Botox is successful

It is ideal to use Botox and more so on the left than right as you indicate and as you show on the pictures you provided. 50 plus units on the right and more on the left and after 2-3 sessions of Botox inections you will notice reduction of the 'square face look' or masseter muscle reduction. The doctors you saw made the correct recommendations to avoid surgery and seek Botox injections. Hratch Karamanoukian MD FACS

Hratch Karamanoukian, MD, FACS
Buffalo Phlebologist
4.8 out of 5 stars 41 reviews

Botox for square face

Thank you for your question and for sharing your photos.  You would be an excellent candidate for Botox in the masseter muscles.

Botox in the masseter region usually takes longer than in the standard areas to take effect. I tend to use anywhere from 15 units (conservative treatment) to 50 units (for someone with really strong masseters) on each side to get the desired result. It may start within the first week but I tell my patients to wait three weeks before doing a more thorough evaluation. The treatment typically lasts longer than the forehead/crows feet/frown regions. It is also a gradual onset of the return of masseter function. I have tried the masseter injections myself and space the treatments around 4 months apart, but use smaller doses to maintain the effect. I normally know the effects are wearing down when I start to clench my teeth more heavily at night when asleep. Once you stop using Botox, the masseter muscles will return to their original baseline when the effects of Botox wears off completely.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 36 reviews

Can I Slim a Square Face with Botox?

You could do so however from the photos provided, the cheeks are relatively flat making the face appear elongated and relatively masculine.  Cheek Augmentation, using fillers or Cheek Implants would make the face more naturally feminine.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Botox Treatment for Square Jawline

Botox injections to reduce a square jawline usually has excellent predictable results, as long as this shape is indeed caused by the masseter muscle, not the underlying bone of the mandible (a simple physical exam will determine this).  Typically 10-20 units per side is necessary, depending on the mass and strength of the muscle being treated, although sometimes I have needed 30 units each side.  If too much is used, you may lose strength in your bite, but this is temporary.  Try to avoid surgical reduction of the underlying bone, as it is costly, has significant recovery, and is difficult to achieve symmetry.

Christopher R. Hove, MD
Paoli Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Botox for a slim face

Please consult a dermatologist or plastic surgeon who can assess your masseter muscles, especially on the left side, to determine if you are a candidate for Botox or Dysport injections.

Martie Gidon, MD, FRCPC
Toronto Dermatologist
5.0 out of 5 stars 22 reviews

Botox (or Dysport) is very good for slimming a square face

You have masseter hypertrophy, which is causing a bulkiness to your lower face, and you are an excellent candidate for neurotoxin to reduce masseter hypertrophy.  You will notice the slimming effect on the lower face within several weeks.  If you like the effect, you will want to repeat your injections periodically.

Melissa Chiang, MD, FAAD
Houston Dermatologic Surgeon
5.0 out of 5 stars 12 reviews

Level of improvement to be expected with masseter reduction with Botox

A way to estimate whether or not you should expect any improvement with masseter reduction using Botox is to stand in front of a mirror.  Look at the angles of your jaw and compare the clenched versus unclenched contour.  Then put each of your hands on each side of your jaw.  Again, feel your jaw when it's clenched versus unclenched.  The muscle at the angles of your jaw you are seeing and feeling is the masseter muscle.  The Botox will reduce the bulk in that area from the muscle, but if your jawbone is still extremely wide despite pressing down on the muscle then you will experience only minimal improvement.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 reviews

Botox and masseter reduction

Based on the photo's you've provided, you look like a great candidate for masseter reduction with Botox. Visiting with a well-trained and reputable provider will help you determine how many units would be needed to achieve an aesthetically pleasing look - and also educate you on a long-term plan.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.