Jaw Injections
Botox has many surprising applications—from disabling sweat glands to preventing migraines—but when you think of major facial contouring, it isn’t the first injectable that springs to mind. However, a recent study by Sydney-based plastic surgeon Steven Liew, MD, published in Dermatology Times showed that the drug can be used to narrow the lower face with, well, jaw-dropping results.
When injected into the masseter (chewing) muscle, botulinum toxin inhibits movement; over time, this causes the muscle to atrophy and shrink. In Liew’s study, which involved 82 female test subjects, all of the patients showed a measurable slimming of the jaw beginning two to four weeks posttreatment, reaching a plateau after three months and lasting up to a year. "The masseter is what we call a ‘stupid muscle,’ meaning it has only one function, which is to chew," Liew says. "It has fewer nerve endings than the areas we inject for frown or smile lines, so the Botox doesn’t dissipate as quickly." Another cosmetic benefit is that diminishing the jaw creates the illusion of a hollowing underneath the cheekbones, which causes them to appear more chiseled. "Many patients say they don’t need to wear blush anymore," Liew says.
Enlargement of the muscle may be genetic (in Southeast Asia, where Botox jaw reduction was first done in 1994, 20 percent of the population is affected by masseter hypertrophy, which Liew has dubbed "square-face syndrome"), or it can be caused by chronic teeth grinding and temporomandibular joint disorder (TMJ), issues that Botox also alleviates, along with the attendant pain.
Any notion that the condition can be brought on by an addiction to Bubble Yum, however, is unsubstantiated. "You’d have to chew a lot of gum to build up that muscle," says New York City and Miami dermatologist Fredric Brandt, MD. "That’s not something anyone should worry about." In cases where the breadth of the lower face is due to bone mass, Botox can still be used, but its effects will be less dramatic. "You can check to see what’s causing most of the enlargement using a CT scan," Brandt says. "Some people are still very happy to have this done rather than go through jaw reduction surgery, which involves breaking and removing part of the bone."
Liew believes that the uptick in patients asking for this procedure is because "an oval jaw is currently considered optimally attractive for women, as opposed to the ’80s, when a stronger, more Sigourney Weaver look was in." But anyone wishing to soften her facial silhouette should proceed with caution. "This procedure is best for younger patients, in their twenties and thirties, without laxity of the skin," Brandt says, "because reducing the muscle is likely to cause more jowl formation in the neck. When you get older, you actually want some of that muscle to hold skin taut." Studies have also shown a slight decrease in chewing pressure posttreatment ("it might be a little harder getting through a steak at first," Liew says), and only experienced derms should be trusted to wield the needle. "If the Botox is injected too far forward on the face," Brandt warns, "you might get some muscle weakness in the lip area, which can affect the smile.
When injected into the masseter (chewing) muscle, botulinum toxin inhibits movement; over time, this causes the muscle to atrophy and shrink. In Liew’s study, which involved 82 female test subjects, all of the patients showed a measurable slimming of the jaw beginning two to four weeks posttreatment, reaching a plateau after three months and lasting up to a year. "The masseter is what we call a ‘stupid muscle,’ meaning it has only one function, which is to chew," Liew says. "It has fewer nerve endings than the areas we inject for frown or smile lines, so the Botox doesn’t dissipate as quickly." Another cosmetic benefit is that diminishing the jaw creates the illusion of a hollowing underneath the cheekbones, which causes them to appear more chiseled. "Many patients say they don’t need to wear blush anymore," Liew says.
Enlargement of the muscle may be genetic (in Southeast Asia, where Botox jaw reduction was first done in 1994, 20 percent of the population is affected by masseter hypertrophy, which Liew has dubbed "square-face syndrome"), or it can be caused by chronic teeth grinding and temporomandibular joint disorder (TMJ), issues that Botox also alleviates, along with the attendant pain.
Any notion that the condition can be brought on by an addiction to Bubble Yum, however, is unsubstantiated. "You’d have to chew a lot of gum to build up that muscle," says New York City and Miami dermatologist Fredric Brandt, MD. "That’s not something anyone should worry about." In cases where the breadth of the lower face is due to bone mass, Botox can still be used, but its effects will be less dramatic. "You can check to see what’s causing most of the enlargement using a CT scan," Brandt says. "Some people are still very happy to have this done rather than go through jaw reduction surgery, which involves breaking and removing part of the bone."
Liew believes that the uptick in patients asking for this procedure is because "an oval jaw is currently considered optimally attractive for women, as opposed to the ’80s, when a stronger, more Sigourney Weaver look was in." But anyone wishing to soften her facial silhouette should proceed with caution. "This procedure is best for younger patients, in their twenties and thirties, without laxity of the skin," Brandt says, "because reducing the muscle is likely to cause more jowl formation in the neck. When you get older, you actually want some of that muscle to hold skin taut." Studies have also shown a slight decrease in chewing pressure posttreatment ("it might be a little harder getting through a steak at first," Liew says), and only experienced derms should be trusted to wield the needle. "If the Botox is injected too far forward on the face," Brandt warns, "you might get some muscle weakness in the lip area, which can affect the smile.
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