Ah Botox, you’ve come a long way since you were first FDA approved in 2002. Not just a wrinkle smoother anymore, you have become the panacea for the cosmetic industry’s many ails. Temporary treatment of frown lines, neck spasms, severe armpit sweating, crossed eyes and twitching eyelids, are the FDA approved uses, but in addition, more than 70 novel off-label medical and cosmetic applications of Botox have been discovered.

One such off-label use that has started to become popular is using Botox for facial contouring. Jaw slimming to be exact. Sounds strange, yes, but hear us out. By injecting botulinum toxin into the masseter (chewing muscle), it inhibits movement; allowing the muscle to atrophy and shrink over time softening a prominent lower face. The cosmetic result of reducing an enlarged jawline is slight hallowing under the cheekbones, making them appear lifted and the face appearing more chiseled. Although, in cases where a square jaw is due to bone structure, Botox injections in the masseter will have little effect on reshaping the face.

While relatively new in the United States, Botox for jaw slimming is very common in Asia having been first done in 1994 in Southeast Asia. Masseter enlargement can be genetic, and is most commonly seen in people of Asian descent, or it can be caused by chronic teeth grinding and temporomandibular joint disorder (TMJ); an issue Botox injections help alleviate.

“Most of us grind our teeth,” says board certified facial plastic surgeon, Dr. Alexander Rivkin, of Westside Aesthetics, “either at night or we clench during the day. It’s an unfortunate reaction to stress. When we are young we haven’t done it very much so there’s little evidence of it. As we get older and we do it more often, the shape of our face changes where the jaw muscles enlarge. It goes from oval and feminine to angular and masculine. When I use botox in the masseter muscle you get a change in the shape of the face back towards an oval, back towards a younger more feminine face. The other part of it is getting rid of the grinding to alleviate the pain and tension in the jaw.”

jaw slimming

(Photograph curtesy of Dr. Karen Horton from the blog post written by Emily Sespaniak)

When injecting Botox to smooth wrinkles results are almost instant. But with facial contouring, visible changes take time. “Usually, it will take one month, sometimes three months to see the full results. It’s muscle atrophy so it takes a while for the muscle to shrink,” explains Dr. Rivkin. And are the results permanent? “Do it once every three months for a year.  After that a lot of people don't need it anymore, but some people may need a touch up once and a while. There are patients that keep needing it because they grind a lot.”

Side effects are rare, but in a study published in The Journal of American Plastic Surgery, chewing fatigue was reported by patents post treatment. And of course, the importance of having this procedure done by a board certified dermatologist or plastic surgeon is paramount for proper injection placement. “If an injection is placed too high or too anteriorly, this can result in undesired weakening of the muscles that pull back and elevate the angle of the mouth during smiling,” says Dr. Melissa Chiang, MD, of Integrated Aesthetics.

Disclaimer: Any information in the publications, messages, postings or articles on the website should not be considered a substitute for consultation with a board-certified dermatologist or plastic surgeon to address individual medical needs. Your particular facts and circumstances will determine the treatment which is most appropriate for you. And the outcomes.

Main photograph provided by Dr. David Kim

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