The use of Botox / Dysport in treating square faces in western people has been used since 1994, but it did not create a lot of interest until recently. This may be because the facial contours in Caucasians tend to be taller, and compared to Asian, they have smaller but longer, narrower faces. So a square face in them tends to be less noticeable and is not generally considered unattractive, leading to the infrequent request for this kind of treatment.

Asian, particularly the Korean, tend to have shorter and wider faces and so the square jaw is more exaggerated and cosmetically more unacceptable. A lot of the initial clinical experience in this came from the Korean.

Causes of a Square Face

It can be due to:
>   Large size of the mandible bone, which is acquired since birth
>   Hypertrophy (unusual enlargement) of the chewing muscles called Masseters.

Masseter hypertrophy can develop from habitual chewing movements or teeth grinding, often unconscious, or frequent chewing of tough foods such as dried squid, or chewing gum.

In the past, treatment for square face has involved surgical reduction of the mandible and partial resection of the masseter muscles. This is very traumatic and carries a big risk of injuries to the salivary glands and the facial nerve, which is not uncommon. Patients have to suffer from prolonged swelling and discomfort after the operation.

If masseter hypertrophy is the cause of the square face, then Botox / Dysport can be considered without any of these risks and so is pretty safe when used correctly.

What You Expect

The muscles start getting smaller after about 2 weeks if you respond quickly, but in some cases the results are not visibly obvious until the second month. Peak effect is seen at 2 - 3 months when the muscle bulk will lose on the average 20 - 25%. It may not sound very much but this % is enough to give you a huge change in facial contour!

In majority of cases, your improvement will last for 6 - 9 months after only a single treatment, and may require a second one after that.

Logically speaking, if you do not allow yourself to chew tough foods or chewing gum again, then it should not recur.

Regarding the side effects, if they do happen, they are temporary. These include mild weakness and pain on chewing, or a change in smiling expression.
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