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The ideal shape for an aesthetically pleasing face has been referred to as “an upside down egg” or heart-shaped.  It is desirous to have the upper face wider than the mid/lower face.  It brings more attention to the eyes, the center of beauty.  Widening of the lower face can give a female a more masculine appearance, and also is a sign of aging. The causes of enlargement of the mid/lower face are:

  1. Enlarged masseter muscles.  Often caused by bruxism (grinding one’s teeth)
  2. Obesity
  3. Genetics.  Asian females tend to have this issue
  4. Jowling associated with the aging face

By injecting the masseter muscles with Botox or Dysport, the muscles can diminish in size and atrophy over time.  If the procedure is repeated and regularly administered, a long-term slimming of the mid and lower face can be achieved.  Candidates for this procedure are people who fall into the #1 and #3 category. Risks are minimal, but this can affect your smile if not done by someone who has experience with the anatomy and performing this procedure.

Many people would also benefit from injecting the temples simultaneously with filler to help create the upside down egg-shape to the face (from a square-shaped face).

For the person that falls into the #2 and #4 category, there is some literature that suggests that Ulthera might be helpful.  Although a much newer technology, Infini might work for this as well, time will tell.  By going to depths that are much deeper than the skin, into the fat layer, it might be possible to decrease the amount of fat in these areas and thereby slim the face.

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