Face Slimming

TREATMENT OF MASSETERS TO SLIM THE LOWER FACE

Face slimming is one of the most popular treatments at our Sydney clinic, especially with our Asian patients. For a beautiful, feminine face shape, like a V shaped face or a heart-shaped face, there should be a curve from upper cheeks to the lower third of the face, rather than a square, round or boxy shape.

Face slimming is a simple procedure which is performed every day by our doctors. We are using a muscle relaxant to slim the masseter muscles, which reduces the width of the lower face below the cheekbones.

Sometimes masseteric hypertrophy is caused by Bruxism, which is the involuntary or habitual grinding of the teeth, typically during the night. This will cause the masseters to enlarge and if left untreated will cause TMJ dysfunction and orofacial pain. Bruxism is often associated with stress.

Antiwrinkle injections(due to Australian regulations, we are not allowed to name the drugs) can be used to treat the hypertrophy of the masseter.

Sometimes large masseters are genetic, and will run in a family.

Small injections with a very fine needle are used to relax and shrink the masseters, causing a slimmed lower face that is more oval and less square appearing.

Before and after jawline slimming injections

Before and after jawline slimming injections for square jawline

Before and after for jawline slimming. Please note the asymmetry in the jawline in the before photo

Before and after injections for masseters: the squareness of the jaw has been reduced

Before and 8 weeks after 1 treatment of injections in masseters for jawline slimming

Before and after treatment for bruxism

Before and after masseter slimming

Before and after injections for facial slimming 1 treatment

Before and after 1 treatment of jawline reshaping with injections

Before and after 1 treatment of jawline reshaping

Before and after masseter slimminginjections

The consultation for antiwrinkle injections for face slimming

History-taking  is very important in the treatment of face slimming. The following should be explored:

  • Is there a genetic component? ie are there others in the family who have a square jawline
  • Has the patient had treatment before? Were they satisfied with results? Did the effect of the muscle relaxing injections last well? Have they every had any complications with muscle relaxing injections before
  • How is the patient’s metabolism? Do they exercise? Are they very muscular? Do they have trouble putting on or losing weight?
  • What is bothering the patient? Is it the appearance of a wide or fat face, headaches related to jaw clenching, TMJ dysfunction or orofacial pain. Does the patient have Bruxism ie teeth grinding? Have they worn down their teeth.
  • Does the patient want a more natural appearance, with some squareness left, or do they want the maximal effect possible, ie a face that is super-contoured and as slim as possible ?
  • What is the age of the patient?

The examination for face slimming injections

The doctor will examine the face and jaw and neck. In particular, she will look at many features, such as:

  • Where the masseters are. How large they are. How straight is the jawline
  • Whether there is an asymmetry
  • How is the elasticity of the skin.
  • The doctor will also feel the size and shape of the masseters by getting the patient to chew while touching the masseter area.

Choosing the number of units for face slimming injections

The doctor will assess the face and neck and decide on the best dose after taking a history and examining the patient.
If the patient has a history of poor longevity, or needing high doses or wanting maximal effect, then a higher dose may be suggested.

If the patient is over 40 or has less elastic skin, then a treatment plan, with multiple treatments of smaller doses may be required.

If a patient has a history of complications with muscle relaxing injections, or if their budget is small or if they want a more subtle result, then a smaller dose might be chosen.

Pain relief during treatment of face slimming

There is very little pain with injections for masseters. Ice is usually the only pain reliever and will help to reduce the risk of bruising
A numbing cream (eg EMLA or LMX ) may be applied to the area prior to the treatment (45 minutes prior is ideal) Glad wrap may be used over the numbing cream to increase its effect.
Most patients do not bother with numbing cream because it takes so long to work and because the treatment isn’t very painful anyway.

Nitrous oxide (Happy Gas) is available for use during injectables, but is not needed for face slimming treatments

What happens during the masseter treatment itself?

Procedure

  • The face will be cleaned with alcohol and chlorhexidine
  • Ice will be applied to the area briefly before treatment
  • The doctor will feel the masseter and then inject 1-5 injection sites per side.
  • Then pressure with gauze will be applied.
    The procedure itself takes less than 5 minutes.

Side effects and risks of face slimming treatment

In general, treatment of the masseters is low risk.

  • Headache happens in around 10% of new users.
  • Bruising occurs in a significant number of cases.
  • Asymmetry: Often one side is better treated than the other, this is usually because the patient is asymmetrical to start with. In some patients they have a much stronger masseter on one side compared to the other. Often it is the side that is favoured for chewing.
  • Infection is a very rare complication, but always a possibility when the needle goes into the skin.
  • There is a low risk of the smile being affected, and smile asymmetries and loss of extreme smiling can also occur. These issues are more likely to occur with larger doses
  • If too large a dose is chosen in an older patient (ie 40 of over), then the skin isn’t as able to retract as quickly and sagging along the jawline can appear to worsen. To avoid this, multiple smaller treatments are recommended to achieve the result more slowly

Who is unsuitable for treatment of masseters?

Most people are suitable for masseters, but as stated above, with older patients, a series of treatments should be followed, with smaller doses, so that the jawline will be able to retract.
Instructions for care afterward:

  • No makeup for 4 hours
  • No massage that day
  • No heavy exercise that day
  • No lying down for 4 hours
  • Avoid acid face/neck  products for 24 hours

What to expect after face slimming treatment?

Mostly immediately after treatment there is nothing to see. Sometimes there can be redness, small lumps, which can look like mild acne and usually resolve quite quickly.
Most people could come during their lunch break during work and go back without their coworkers noticing anything. The effect of the injections will not start to occur for a few weeks. Patients may  start to notice a slimmer face from about 4 weeks, but this will continue to increase until the 8 week point
The maximal effect of the drug will be at 8 weeks, so a review should not be booked before 8 weeks. If at that time, further treatment is necessary, it should be performed. Photographic evidence of improvement should start to occur at 6 weeks.
Also, results will always be best with masseters after multiple treatments as the masseter atrophies

What do I do if at 8 weeks post treatment one side is better treated than the other or I am not as slim as I want to be?

These issues above are not uncommon. At your 8 week review appointment, further treatment may be administered if further improvement is wanted by the patient. There are no “free top ups” with face slimming treatments. All product will be paid for. The doctor will first have to assess if further improvement is possible

How long will the treatment last?

The answer to this is very individual and depends on the patient’s metabolism, the dose, the placement etc.
Typically this is what happens:
At 8 weeks, there is a maximal effect
at 16 weeks 80% of movement should be back.
Over time,

When should I have my next treatment for muscle relaxing injections in masseters?

Second treatment should be at 8 weeks if the patient would like the jawline smaller. Second treatment should be at 3-4 months if patient is happy with the amount of slimming at 8 weeks.

Over time of regular injecting (approx 2 years), many patients find that they do not need their treatments as regularly or with as high doses.

How much does it cost for the muscle relaxing injections in masseters for jawline slimming?

$360-$1150, it will cost less if combining with treatment using the same drug in other areas of the face. Commonly in the reducing phase of treatment, cost is approx $830. Maintenance after 2 years of regular injecting may be less.

This patient has always hated her round face, so we regularly slim her masseters to give her a more oval look

before and after bruxism treatment

Don’t forget your jawline slimming…

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