Thank you for your question!
You stated in your question which you didn’t submit with a photo that you have mild sagging
along your jawline and your doctor suggested Botox™ injections in masseter muscle and
you’re asking if that would cause more sagging and you’re not sure whether or not to proceed.
Well, I can certainly assist you with this question even with the absence of a photo.
A little bit of background, I’m a board certified cosmetic surgeon and an oculofacial
plastic and reconstructive surgeon. My practice focus amongst several areas includes facial
aging including face lifting, eyelid rejuvenation and non-surgical solutions for facial aging
and I can certainly give you an opinion from my experience of using Botox™ which I have
been using for patients since the early 90s and I’ve been in practice in Manhattan and
Long Island for over 20 years.
To understand the concept of how to improve a jawline that is sagging, there is certainly
a legitimate question here as to the value of using Botox™ to relax or to reduce the
masseter muscle. The masseter muscle is a strong muscle that is important muscle for
chewing. And in certain people where they have thickened masseter muscles where they
find the bulge of the muscle to be undesirable, there is a role for Botox™ to reduce the
volume that muscle of course without affecting the functionality of the muscle.
So when you ask about sagging, I think that there may be some misinterpretation and there
are some methods of using Botox™ which can slightly improve the appearance of a sagging
jawline. To share with you, our approach in our practice that is non-surgical which is
clearly what you’re interested in because you’re asking about Botox™, I would actually
say that there is a valuable role of the masseter muscle and as well as other muscular structures
along the jawline. There is a procedure we perform in our practice called the Y Lift
and the Y Lift is based on this concept of using fillers such as Juvederm, Ultra Plus
and Voluma in a very specific and elegant way that works under the muscles and it allows
the restoration of volume. You know, when you think about sagging and I’ve written
about this in a book that I did for consumers years ago where understanding aging, there
is volume loss and there is sagging. So when you’re describing sagging in the jawline
that is very little, there’s a good chance that most of your issue has to do with volume.
So in contrast to a surgery like a facelift where we lift the skin and soft tissue and
muscle to more hug the solid structure of the face, with Y Lift, what we’re doing
is we’re placing volume on the structure of the face and it’s referred to as structure
volumizing for a reason, going along the cheekbones, the jawline. You not only get better definition,
the whole face looks younger.
Now we can also do limited areas such as the jawline or just the cheeks alone but the point
is that if you’re looking for an injectable solution for the jowling, I think it’s worth
considering this type of procedure as opposed to using Botox™ for the masseter which I
don’t think would be much of a value. It might be that your doctor feels that the continuity
of your jaw may be improved by reducing the volume and maybe making the jaw look straighter
but I think it’s an indirect method and I don’t think it’s going to generate a
type of result you’re looking for.
So I would recommend that you learn more about the Y Lift and consider this option and just
think about two ideas: there’s volume loss and there’s sagging. So with a certain level
of sagging, you can’t put enough filler so that’s an important distinction. There
are times where surgery is the only solution to get the kind of result that you want. But
I think it’s worthwhile considering if you have only a slight bit of sagging, this technique
called the Y Lift.
So I hope that was helpful, I wish you best of luck and thank you for your question!