Facial liposuction combined with botulinum toxin type A: A technique for lower facial contouring

Background: Botulinum toxin type A injection, a noninvasive alternative method for treating masseteric hypertrophy, is inadequate for treating patients with a round lower face. This study aimed to investigate the operative technique and clinical results of liposuction followed by botulinum toxin type A injections in patients with masseteric hypertrophy and excessive subcutaneous fat. Methods: Sixty-five patients (50 women and 15 men) were treated using this technique between May 2014 and January 2019. Their mean age was 26.3 years (range, 18–35 years) and the mean follow-up period was 13 months (range, 8–18 months). Results: All patients achieved slimmer lower cheeks with improved jaw definitions after the procedure. Among the 65 patients, 61 (94%) expressed satisfaction with the results and believed that the procedure produced their desired face shape. No major complications were observed. The effect of this combination treatment remained stable for 12 months after the procedure. Conclusion: The authors believe that liposuction followed by botulinum toxin type A injections is an effective technique for the treatment of masseteric hypertrophy and excessive subcutaneous fat. It is also a relatively simple and safe treatment approach