Masseter Botox and Jowls/Marionette Lines (Photo)

Based on your photos, your masseter muscles appear to be on the large side. An examination would be needed to confirm this. Do you chew gum? Do you have TMJ issues? I am not aware of TMJ Botox leading to marionette grooves. You appear to have grooves at the corners of your mouth on both sides and depending on your examination, this may be improved with an injectable filler treatment. I hope this is helpful! Sincerely, Dr Joseph

Thank you for your question and for providing photos. Masseter Botox primarily targets the masseter muscles on the sides of the jaw, reducing their size and resulting in a slimming effect on the lower face. While it is generally considered safe and effective for facial reshaping, there are potential concerns about changes in facial dynamics that could lead to jowl formation or accentuated marionette lines. Most people have enough elasticity in their skin that it can accommodate the changes that Botox to the masseter is making.

A skilled plastic surgeon or injector will carefully assess your facial structure before recommending any treatment. By evaluating the overall balance and harmony of your face, they can better understand how different treatments, like masseter Botox, may affect your appearance.

I recommend scheduling an in-person consultation with a qualified and skilled injector who can evaluate your concern and determine the treatment plan suited to your needs and goals. Dermal fillers may also be recommended to support the muscles in your lower face.

I recommend fillers to soften the nasolabial folds themselves and also lift around the mouth and cheeks to build underlying anatomical support. In our practice we combine Sculptra with other fillers "layered" on top and lasers, skin tightening treatments such as Thermage, Fractora, and Renuvion (J Plasma), thread lifting, and peels to get the most conservative, natural look. I suggest seeing a facial sculpting expert for a formal consultation. Best, Dr. Emer

Botox treatments can offer a quick and simple solution to address lines and a downturn at the corners of the mouth. A few small injections will smooth the lines and relax the muscles pulling down the corners of the mouth for a more pleasant lip appearance and also fillers can help add support and structure to uplift the mouth and restore your smile back to its natural position. Think of it as the filler acting as invisible scaffolding supporting and lifting the corners of your mouth. A filler can be used to temporarily lift the corners of a downturned mouth by providing support to the lip corners.

Botox should be used to address the areas that concern you. If you are concerned with the size of your lower jaw then Botox can be used to help slim this area. The effects of Botox are temporary, typically lasting three to four months and wearing off gradually over that time. Results will vary. If you are nervous you could begin conservatively to determine if you like the effect. Just be aware that the product may not last as long. If jowls or marionette lines are concerns then filler can be used to address them.