Does Masseter Botox Cause Jowls? What You Should Know About Facial Balance

Does Masseter Botox Cause Jowls? What You Should Know About Facial Balance

Masseter Botox is best known for jaw slimming, facial contouring, and relieving TMJ pain—but a common concern we hear is whether this treatment might cause jowls or facial sagging. It’s a valid question, especially if you're investing in Botox to look more youthful—not older.

Here’s the truth: Masseter Botox can contribute to jowling in certain individuals, but it’s not a guaranteed side effect—and it’s usually preventable with the right technique and candidate selection.

Let’s look at what causes this, and how to avoid it.

Why Would Masseter Botox Cause Jowls?

The masseter muscle supports the lower face. When it’s injected with Botox to relax and shrink, it can reduce muscle bulk, creating a softer, more contoured jawline. However, in rare cases, this loss of volume or muscle support may result in:

  • Mild skin laxity near the jawline

  • Loss of definition where the cheek meets the lower face

  • A “sunken” look or slight jowling in patients with naturally thinner faces or loose skin

This effect is more likely to occur if:

  • The masseter is overtreated

  • Facial volume is already low (common in people with thin or aging skin)

  • The injections are performed by someone without advanced training in facial anatomy

Who’s at Higher Risk of Jowling After Botox?

Jowling from masseter Botox is uncommon, but more likely in:

  • Individuals over 40 with some skin laxity

  • Patients with a naturally low body fat percentage

  • People receiving high-dose Botox in the masseter region over a long period

The good news? A skilled injector can prevent this. Dr. Okada is a board certified plastic surgeon with years of experience evaluating patients’ facial structures. She would recommend masseter Botox using an approach that won’t compromise your face and skin’s support system.

How to Prevent Jowls With Masseter Botox

To reduce your risk of jowling, we’ll sure your treatment plan includes:

  • Conservative dosing: Start with a smaller amount to gauge how your muscles respond

  • Proper injection technique: Avoid placement that weakens supporting muscles like the risorius or buccinator

  • Combination therapy: In some cases if you are adamant about moving forward, we may recommend adding filler likeJuvederm to the cheeks or jawline to maintain balance

What If You’ve Already Noticed Jowls After Botox?

If you’re seeing slight jowling or volume loss after masseter Botox, don’t panic. Most cases are mild and temporary. Options for correction include:

Pausing Botox treatments to allow the masseter to recover

Strategic dermal fillers to support the lower face and lift sagging tissue

Skin-tightening procedures such as TriLift or other non-surgical options

The Bottom Line: Masseter Botox Should Never Age You

When done correctly, masseter Botox should enhance your look—not age it. The key is expert planning, balanced treatment, and understanding how different parts of the face interact. A well-trained provider knows how to achieve slimming without sacrificing structure or support.

At Stratus Plastic Surgery, we take a conservative, tailored approach to Botox and facial injectables. Whether you're concerned about jowls or simply want to enhance your natural contours, our board-certified surgeon and team are here to help.

Talk With a Provider Who Understands Facial Balance

Masseter Botox is a powerful tool—but like all injectables, it should be used with precision. If you’ve been hesitant because of jowl concerns, the best first step is a conversation with someone who specializes in facial anatomy and aesthetics.

Schedule your consultation today and let’s map out a plan that helps you look refreshed, defined, and completely confident—without unwanted side effects.

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