July 21, 2026 | Injectables
A patient came in last winter unhappy with the shape of her lower face. The jaw looked wide and square to her, more masculine than she wanted, and she had walked in braced to hear that surgery was the only fix.
It was not. The answer was a few units of Botox placed in exactly the right muscle. That conversation, anonymized from real consultations, is the one I want to share, because masseter Botox is one of the most underused treatments I offer.
What Masseter Botox Actually Does
It relaxes the big chewing muscle, the masseter, along the back of your jaw. Overdevelop that muscle, usually from clenching or grinding, and it bulks the lower face out wide and square.
Soften it and over the following weeks the jaw draws in, so the face reads more oval and more feminine. You get that tapered lower third, and nobody can tell you had anything done.
How Long It Lasts
The masseter behaves differently from regular Botox. Treat the forehead or the eyes and you get about three to four months. The masseter holds far longer, usually around six, because of how that muscle responds to being relaxed. So you are not keeping up with it as often. We treat it, you enjoy it for half a year, then we touch it up.
How I Decide the Dose
It rides on the strength of your muscle. First time, if the masseter is strong, I may treat it more fully, an even split across both sides. Once a prior round has softened it, we back off, because now we are maintaining rather than starting cold.
What I am after is a balanced, even result so the jaw narrows symmetrically. I would rather build the effect gradually than overdo it in one sitting.
Can It Help Feminize My Face?
Yes, and that is one of the things I love about it. Narrowing the jaw does much of the work in softening a masculine or very square lower face. Bring the angle of the jaw in and the face turns more heart-shaped, more feminine, in a way that reads natural rather than surgical. People notice you look better. They do not notice why.
What About My Chin?
The chin works in concert with the jaw. Sometimes, once we have narrowed the sides, a little projection in the middle of the chin finishes the look, keeping it pointed and feminine instead of wide. That can start as a small amount of filler.
For something permanent, I reach for a button-style chin implant. A button projects the chin straight forward rather than widening it, so the chin reads narrower and you get that clean shadow underneath the jawline everyone is after.
Filler or Implant for the Chin?
| What You Want | Filler | Chin Implant |
|---|---|---|
| To preview the look | Ideal | Not for previewing |
| A lasting result | Temporary | Permanent |
| The role it plays | Refine projection now | The long-term fix |
Filler is a great way to preview the look and refine projection in the moment. If you want a lasting result, a chin implant is the better long-term tool. The two pair naturally with masseter Botox. Relax the jaw to narrow the sides, then add projection in front, and the whole lower face comes into balance. When a patient needs true lifting rather than reshaping, that is a different conversation, closer to a facelift, and I will say so plainly.
Why I Take the Lower Face Seriously
I am a double board-certified plastic surgeon, certified by the American Board of Plastic Surgery and the American Board of Surgery, with a Mayo Clinic plastic surgery fellowship and thirteen consecutive years as a Castle Connolly Top Doctor. I treat the lower face as one connected unit, the masseter, the jawline, and the chin together. A few units of Botox in the right muscle, sometimes paired with a little chin work, can reshape a face more than people expect. Done well, it looks like you, just more refined. The injectable side of this lives at our colleague practice’s Med Spa.
Ready to Talk?
If your jaw has always looked wider or squarer than you would like, masseter Botox may be the simplest fix, no surgery required. Come in and let me take a look.
For the surgeon’s editorial take, see the companion essay on drworldwide.com. For the El Paso treatment menu, see the version on swplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com. #StayBeautiful.
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