Dr. Joseph Hkeik
The trend that took off in Asia has made quite the global statement in recent years. Masseter reduction or jawline slimming has become a common treatment for softening and slimming down the face shape.
RESCU sat down with Dr. Joseph Hkeik to find out exactly how the treatment is conducted, the plus sides and potential down sides of changing your jawline and the nitty-gritty detail involved in the overall transformation.
RESCU: Can you tell us about this trend that’s emanated from Asia, Korea specifically, about softening the square, super hero jawline to make it a little bit softer and slimmer?
Dr Joseph Hkeik: As you mentioned, it started in Asia. A lot of Asian faces are quite broad at the jawline and they have big masseter muscles and instead of having that v-shape face that comes down from the cheek to the chin, they start to go to the outside and it’s square.
It’s not feminine, it’s masculine for a woman, so we reduce the bulk of the masseter. As you know botox is high in doses and I’m not a big fan of big doses of botox. It makes muscles shrink, so what I do to upper face botox is keep the dose to the bare minimum.
One, it reserves the muscle, because it needs to keep the muscle from moving, if you freeze the muscle for a long time it will shrink.
Two, it gives a more natural result to the upper face. For the jawline, the masseter muscle is the muscle responsible for the mastication and chewing really hard foods, like steak. People that eat a lot can actually gain bigger masseter muscles and its also related to the temple. Very often, if it’s related to eating, you’ll see that the muscles on the temple and jawline is much bigger.
But for females that have a big masseter muscle, we get them to clench their teeth, feel the muscle, and inject doses of botox at two or three points. Usually it can range between 20 – 40 units of botox per muscle. What it does is it shrinks that part of the face, as it shrinks, it makes a v-shape or oval face for the patient.
RESCU: How often will they get that treatment?
Dr Joseph Hkiek: Initially they may need to do it every 3 months, then 2 or 3 times after that. The muscle will take a long time to recover before going back to its original size. I’m not a huge fan of putting too much botox in one area. So, what I try to do is spread it over a bigger period.
RESCU: Why don’t you like it?
Dr Jospeh Hkiek: Because I think you’re stopping a muscle completely. People can have problem with chewing.
RESCU: Does it affect how you hold your mouth?
Dr Joseph Hkiek: Not so much holding your mouth, but it will affect how you chew red meat. This is why I like to go gently with botox and not inject high doses. I like to do it a drop at a time. I discuss this with my patients so they understand.
RESCU: So, is botox the only thing you can use or would you also need fillers?
Dr Jospeh Hkiek:. For slimming the face you put botox in the masseter muscle. Men come to me and want to have a really rapid jawline. I build that in with filler for them, in the same area because I need to increase the volume.
So, I use my own technique and go from the mandible line and in one entry point, I spread the filler to mimic what a natural jawline would look like, and that will give them a nice square shape. It’s a treatment that’s really popular with men, especially men over 30. It lasts for about a year to two for some patients, and it looks very masculine.
Another thing we do for a woman’s jawline is add in fillers. It’s becoming a common treatment with women over a certain age. Women lose a lot of volume on the lower third of their face because of model changes. The bone that supports the chin, jaw and teeth, shrinks a little bit and as a result it caves in. So, I put a lot of volume in this area, and often this is the first area they come to me for.
Men actually get stronger in the chin compared to women. They get more bone in the forehead so you get a stronger jawline and the chin comes out. That rectifies the problem for them in the chin, but they lose it. So, we reestablish that and put fillers for them near the ears to the mandible angle. So, we’re trying to connect it, so they still have a nice, sharp angle.
RESCU: What is the cost typically for 20-40 units of botox in forehead to slim your face?
Dr Jospeh Hkiek: It is between $350 – $700. So, the recommended dosage is 40-40. So, almost like $1,400 to do both sides. But I believe you should do 20-20 or 10-10, so that’s $350 – $700.
For the filler, 1 – 2 millilitres cost between $785 – $1,570.
I don’t like to go and fix one area, I do 1 – 2 millilitres and do a full-face rejuvenation and top it up down the track. It’s a building in progress; you’re not really going in and fixing a part of your face. You want your full face to be always good, so face is one unit. And we treat the face.