Botox or any other neurotox to the masseters is a popular and wonderful treatment. In 3 months or so, it is possible to reduce the masseter (jaw muscle) volume by 30% or so, and this makes the face look slimmer and more V-shaped. When we do this, the muscle weakens and becomes smaller. Patients require touch ups 2-4 times a year to maintain the result. Accordingly, the face narrows posteriorly. One negative side effect of this is that there may be (intentional) weakening the jawline angle. Sort of the opposite of jawline filler. This is typically overlooked as patients are satisfied with a relatively safe, reversible, and non-invasive nature of this treatment. However, in some patients, and those who often request Botox for their masseter muscles, the soft tissue in front of the masseter muscle, in the anterior one half of the face, may become relatively more prominent. Because structures like jowls may be hidden by fullness of the masseter muscle, correction of masseter hypertrophy exposes a different anatomic problem area for some patients. In our practice, we are seeing this more and more, and we typically treat this so-called “masseter atrophy deformity” (M. A. D.) with filler along the jawline to recapitulate mandibular continuity. In this video, we explore a typical case of M.A.D. and offer a safe, predictable, and anatomic solution. This is a brilliant strategy to enjoy the slimming effects of masseter paralysis without losing jawline definition.

Please note: this does not represent medical advice and only board-certified plastic surgeons or their immediate delegates should perform both masseter toxin treatment and filler to the jawline due to an abundance of blood vessels, nerves, and other critical structures in the vicinity.

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