Cheekbone Reduction

Q: Dr. Eppley, I have always felt that the areas right inferior to my zygomatic archs are way too thick and hard and widened.I am not sure about the specific name of that muscle, but pretty sure it is not due to bone.I know that Botox is commonly used to reduce jaw angle, but I don’t even have an angle so I don’t know whether it will help, as it is like the area above masseter muscles (or it really is upper masseter muscle?).

A: Botox will not be an effective or prudent treatment for the area you have highlighted for the following reasons:

1) There is a significant risk that Botox injections placed in this area will inadvertently paralyze the frontal and buccal branches of the facial nerve, thus rendering your forehead, eye and upper lip areas paralyzed for the duration of the effects of Botox. (around 4 months)

2) The upper masseter muscle in this area is largely more fascia than muscle thus making it far less responsive to reduction than that of the jaw angles

The effective method of reduction would be check bone reduction (zygomatic arch reduction) to carry the attachment of the soft tissue inward with the bone.

Dr. Barry Eppley
Indianapolis, Indiana