There are a variety of uses for Botox in our Seattle cosmetic injection practice. The treatment of excessive facial width using Botox has become more popular in the past few years. We see a number of younger patients each week who are troubled by their wide lower facial shapes. They often comment on the desire to narrow the jawline and create an oval or almond shape to the lower face. Other patients dislike the square appearance to the lower face.

There are a variety of facial structures that contribute to facial width, including the bone mass of the jaw bone (mandible), the bulk of the buccal fat pad and the thickness of the masseter muscles.

There are two masseter muscles, one on each side of the cheek. This muscle connected the cheekbone to the jawbone (zygoma to mandible) and is one of the three muscles that power the chewing motion of the lower jaw. When the masseter muscle becomes thickened, due to genetic factors or constant teeth grinding (bruxism), the muscle can bulk up and add to the facial width.

We can use Botox for masseter treatment to weaken and thin the masseter muscle over time. This narrows the lower third of the facial width. Botox is used in sufficient amounts to partially denervate the masseter muscle and induce some mild muscular atrophy. This does produce slight weakness in chewing 'power', but most patients don't complain about this mild side effect. 

A typical starting dose for masseter Botox is about 50 units per side of the face. Retreatment is done every six months, which is less frequent than Botox injections for facial expression lines. Most patients notice a difference in facial shape within a few weeks of the treatment. Other patients notice a reduction in their teeth grinding (bruxism) at night.