Botox in the jawline. Does this cause further sagging of skin?

Thank you for your question. You say you have mild sagging along your jawline, for which your doctor suggested Botox™ injections in the masseter muscle, but you’re worried this may cause more sagging.A bit of info on my background — I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years. A big part of my practice is focused on facial aging and facial rejuvenation, so I can certainly share my experiences in using Botox™, which I’ve been using since the early 90s.The masseter muscle is an important muscle for chewing. Some people have a thickened masseter muscle that produces an undesirable looking bulge. In such cases, there is a role for Botox™ to reduce the volume of that muscle without affecting its functionality.What we do in our practice in order to address the masseter muscle, as well as the other muscular structures along the jawline is a procedure called the Y Lift™. The Y Lift™ makes use of fillers, such as Juvederm Ultra Plus and Voluma, which are then placed in a very specific and elegant way in the deeper structural levels of the face, under the muscles and near the bone structure. It restores volume and definition to areas like the jawline and chin.I think there may also be a slight misinterpretation of the term “sagging”. It’s important to understand that there is sagging and there is volume loss. When you describe sagging in the jawline that is very little, it is more likely that most of your issue has to do with volume. So rather than performing a surgical facelift where we lift the skin, soft tissue, and muscle, we can instead place volume in the deeper structures of the face. You not only get better definition, the whole face looks younger. The beauty about this procedure is that you can do it on specific areas of the face, such as only the jawline, or only the cheeks.I think your doctor may have felt that the continuity of your jawline may be better improved by reducing the volume of the masseter muscle and by perhaps making the jaw look straighter, however, I think it’s an indirect approach that may not generate the type of result you’re looking for. I recommend that you learn more about the Y Lift™. I think this may be a worthwhile option to consider, especially if you only have minimal sagging.I hope that was helpful and I wish you the best of luck!

Thank you for your question. The masseter injection decreases the bulk of that particular muscle. It is unlikely it will effect the surrounding volume. That being said, it may effect the skin around the masseter muscle. Best, 

Botox in the masseter muscle can be used to decrease masseter muscle hypertrophy or for patient's that grind their teeth.  A larger masseter is usually associated with a more masculine jawline and may provide some support to lateral sagging of skin.  Masseter muscles take time to shrink with repeated botox injections and is a slow process, but these injections usually do not help with sagging skin.  Generally, to improve the jawline, botox is used in the neck (platysma) and lip depressor muscles; these injections can lift the neck and corners of the mouth.