Alar Botox vs Nose Contouring Injection: Which Fits Your Alae?

Hello. This is Dr. Song Myung-seung of NUWA Clinic Gangnam, where we assess the concern before the treatment.

Over the past ten years, assessing a great many faces, there is one thing I have felt again and again. Square jaw concerns may look similar from the outside, but the actual cause differs from person to person.

In the clinic I am often asked, “Will square jaw botox make my face slimmer?” Most people arrive thinking of botox first when it comes to a square jaw. But when we trace the jawline together in front of the mirror, there are surprisingly many cases where botox is not the answer. Today, drawing on cases from the clinic, I will go through when square jaw botox is a good fit and when it is not.

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Why a year of square jaw botox changed nothing

There was a patient whose muscle had already reduced, yet whose jawline was unchanged.

A patient in her thirties came to us having had square jaw botox at regular intervals for over a year, saying the jawline was exactly the same. When we checked the jawline together in the clinic, the masseter (the chewing muscle) had in fact already reduced sufficiently. The muscle had reduced, so why was the jawline unchanged? The reason is simple. What was making her jawline look heavy was not muscle. With a square jaw, you have to see the cause accurately before you can know which treatment fits.

When square jaw botox does work

Square jaw botox can help where a developed masseter makes the jaw look wide.

What we commonly call a square jaw goes by a single name, but the actual causes are several. The first thing checked here is the masseter. If the muscle at the side of the jaw feels firm when you clench, or bulges outwards, that may correspond to a developed masseter. Where a developed chewing muscle makes the jaw look wide, reducing the size of the muscle with botox can help. This is what is commonly meant by square jaw botox being a good fit.

When square jaw botox does not work

If what covers the jawline is not muscle, repeating botox will not change the jawline much.

Besides muscle, the causes that make a jawline look heavy divide broadly into three.

First, fat. Where fat settles under the chin or in the lower cheek and makes the jawline look heavy, the cause is not muscle, so repeating botox may not bring the jawline back as much as hoped.

Second, sagging. When tissue from the cheeks and around the mouth descends and rests on the jawline, the jaw can look angular even where the jawbone itself has not grown. This proportion increases with age.

Third, a developed jawbone (the mandibular angle). Here there may be limits to what an injection alone can do, so honestly confirming the range of change that is possible comes first.

If the muscle has been reduced sufficiently and yet there is little change in the jawline, there is a strong possibility that the answer lay outside the muscle from the start.

What is causing my square jaw? Assessing the jawline

With a square jaw, before the jawbone, we look at what is covering the jawline.

In the clinic we check three things: whether the masseter can be felt firmly when you clench, whether fat can be felt under the chin or in the lower cheek when relaxed, and whether the jawline tidies up when the cheek is lifted slightly. Through this process we distinguish whether the main cause weighing down the jawline is muscle, fat or sagging. For those who have already had botox several times in particular, the muscle may already have reduced, so we look all the more carefully.

How the treatment was actually carried out

In that patient’s case, what was making the jawline look heavy was not the masseter but sagging in the lower cheek and fat under the chin.

Had botox alone been repeated, the muscle would have reduced further, but the sagging and fat covering the jawline would have remained, so the change she wanted would most likely have been hard to feel. So rather than shortening the botox interval, we built a plan that looked first at the sagging and at tidying the line. The sequence was to support the lower cheek sagging with Ultherapy first, carry out Titanium Lifting alongside to tidy the jawline, and address the fat under the chin lightly and separately. This is why, with the same square jaw concern, the order in which things are addressed differs according to the cause.

(Any related photographs are unretouched originals taken at the same angle, lighting and distance, and results may differ according to the individual.)

What to check before having square jaw botox

If a square jaw is on your mind and you are looking into botox, it is better to check what is making the jawline look heavy before settling on a treatment.

If muscle is the cause, botox can help. If fat is the cause, tidying under the chin and the lower cheek may be needed. If sagging is the cause, a lifting direction needs to be considered alongside. If bone is the cause, it matters that we tell you honestly what range is possible with a treatment. Because even with the same treatment, the result differs according to where and how it reaches.

In closing

The effect of square jaw botox ultimately rests on whether what is making your jawline look heavy is muscle.

If muscle is the cause, botox helps; if fat, sagging or bone is the cause, botox alone has its limits. So I look at position before dose, and at the flow of the patient’s face before position. If a square jaw is on your mind, I will look at the cause with you before the treatment.

This has been Song Myung-seung of NUWA Clinic Gangnam, where we assess facial shape concerns first. NUWA Clinic Gangnam is located directly in front of Exit 7 of Gangnam Station, on floors 3 and 4 at 385 Gangnam-daero, Seocho-gu, Seoul.

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Frequently asked questions

Q. How long does square jaw botox last?

A. With botox, muscle movement gradually returns over time. How long it is maintained differs individually, so we advise on this after assessment.

Q. I have had square jaw botox several times with no effect. Why is that?

A. If the masseter has already reduced and yet the jawline is unchanged, there is a strong possibility that the cause is fat, sagging or bone rather than muscle. In that case it is right to look for the other cause first, rather than have more botox.

Q. Can I check at home whether my square jaw is down to muscle?

A. If the muscle at the side of the jaw feels firm or bulges when you clench, that may be a developed masseter. That said, the accurate cause is best confirmed through consultation.

Q. What do I do if botox does not reduce my square jaw?

A. If the cause is fat, we consider tidying under the chin and the lower cheek; if it is sagging, we consider a lifting direction alongside. We advise on the direction that matches the cause after assessment.

*Treatment direction and results may differ according to the individual, and an accurate assessment is given through consultation at the clinic.