Botulinum Toxin for Masseter Reduction in Asian Patients

Asian patients frequently seek aesthetic alteration of hypertrophic masseter muscles to reduce a prominent mandibular angle. Surgical reduction is common in Asia, but botulinum toxin offers a less invasive approach. This pilot study evaluated results of aesthetic lower face narrowing in 20 Asian patients. Initially, 25 U of botulinum toxin (5 U/0.1 mL) was injected at each inferior masseter border; an additional 25 U was injected per side as needed at 1-week intervals. Seven patients (35%) required only 1 injection; 10 (50%) required 2; and 3 (15%) required 3 injections. Maximum reduction was seen at 1 to 2 months; more prominent hypertrophy yielded the most impressive results. Maintenance reinjection took place at 6 to 8 months. Up to 12 months of follow-up is reviewed herein. Two patients (10%) complained of mild fatigue after vigorous chewing and 1 developed mild transient buccal weakness. Nineteen of 20 patients were satisfied.