Narrowing the Jaw at the Med Spa: Dr. Agullo on Masseter Botox and Facial Balance
A lot of people think Botox is only for forehead lines and crow’s feet. One of Dr. Frank Agullo’s favorite uses sits lower, in the masseter, the chewing muscle at the angle of the jaw. When that muscle is strong, he explains, it widens and squares the lower face. Relax it, and the jaw narrows, softens, and looks more feminine. No incision, no downtime.
Here is how Dr. Agullo talks patients through it at the Southwest Plastic Surgery Med Spa, offered as education rather than a recommendation for any one face.
What Masseter Botox Actually Does
It relaxes the big chewing muscle along the back of the jaw, Dr. Agullo says. When that muscle is overdeveloped, often from clenching or grinding, it makes the lower face look wide and square. Softening it lets the jaw narrow over the following weeks, so the face reads more oval and more feminine. Patients get that tapered lower third without anyone being able to tell they had something done. These injectables live at the Med Spa.
How Long It Lasts
The masseter is different from regular Botox. When Dr. Agullo treats the forehead or the eyes, that lasts about three to four months. The masseter holds much longer, usually around six months, because of how the muscle responds.
| Area Treated | Typical Duration |
|---|---|
| Forehead, glabella, crow’s feet | About three to four months |
| Masseter (jaw) | Around six months |
How the Dose Is Decided
It depends on the strength of the muscle, Dr. Agullo explains. The first time, if the masseter is strong, he may treat it more fully, an even split on both sides. Once the muscle has already been softened from a prior round, he can do less, maintaining rather than starting from scratch. The goal is a balanced, even result on both sides so the jaw narrows symmetrically, and he would rather build the effect gradually than overdo it in one sitting.
Softening a Square Jaw
Narrowing the jaw, Dr. Agullo says, is a big part of softening a masculine or very square lower face. When the angle of the jaw comes in, the face looks more heart-shaped and more feminine, in a way that looks natural rather than surgical. People notice the patient looks better, not that they had work done.
How the Chin Completes the Look
The chin works together with the jaw. Sometimes after the sides are narrowed, a little projection in the middle of the chin finishes the look, so it stays pointed and feminine rather than reading wide. That can start as a small amount of filler. For a permanent change, Dr. Agullo uses a button-style chin implant, which projects the chin straight forward instead of widening it, making the chin look narrower and giving that nice shadow underneath the jawline. Filler previews the look, and the implant is the lasting tool. The two pair naturally with masseter Botox. When a patient needs true lifting instead of reshaping, that is closer to a facelift, a different conversation entirely.
About Dr. Frank Agullo
Dr. Frank Agullo is the founder of Southwest Plastic Surgery in El Paso, Texas. He is double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, a Fellow of the American College of Surgeons, and a Mayo Clinic plastic surgery fellowship alum. He is a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine and has been named a Castle Connolly Top Doctor for thirteen consecutive years. He treats the lower face as one connected unit, the masseter, the jawline, and the chin together.
Ready to Talk?
If your jaw has always looked wider or squarer than you would like, the team at Southwest Plastic Surgery can tell you whether masseter Botox is the simplest fix.
For the surgeon’s editorial take, see Dr. Agullo’s essay on drworldwide.com. For the patient-facing version, see the companion post on agulloplasticsurgery.com.
Call (915) 590-7900, text 1-866-814-0038, or book online at swplasticsurgery.com. #StayBeautiful.
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