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Botulinum Toxin Injections for Masseter Reduction in East Asians

Cheng, Judy, MD, MPH*; Hsu, Sarah H., MD; McGee, Jean S., MD, PhD*

doi: 10.1097/DSS.0000000000001859
Review Article

BACKGROUND Cultural ideals for a slimmer face have led to an upsurge in interest in facial contouring among East Asians. Although surgical resection has traditionally been the main treatment option, botulinum toxin injection is becoming a popular, noninvasive alternative.

OBJECTIVE To describe the use of botulinum toxin injection for masseter reduction in East Asians.

METHODS An electronic search of the PubMed database was performed for studies published from 2000 to 2017 that meet the word combination of botulinum toxin, masseter, hypertrophy, and/or lower face contouring. Only the studies conducted in East Asian countries were analyzed in this review, exception of one study from Thailand.

RESULTS A total of 12 publications were identified. Each study was reviewed to extract relevant information on patient selection, injection techniques, efficacy, dosage, frequency, and main side effects of treating masseters with botulinum toxin.

CONCLUSION Botulinum toxin injection for masseter reduction in East Asians is efficacious and generally considered safe with no significant side effects. Future areas for investigation include defining the criteria for benign masseteric hypertrophy, minimum effective dosage of botulinum toxin, and the potential long-term effects of the injection.

*Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts;

Maryland Dermatology Laser, Skin, and Vein Institute, Hunt Valley, Maryland

Address correspondence and reprint requests to: Jean S. McGee, MD, PhD, Department of Dermatology, Boston University School of Medicine, 609 Albany Street, J-505, Boston, MA 02118, or e-mail:

The authors have indicated no significant interest with commercial supporters.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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