title: Nonsurgical reshaping of the lower face.
abstract: BACKGROUND
  The use of botulinum toxin in aesthetic reshaping of the mandibular angle has been well established in East Asian populations. This has not previously been investigated in Western populations.
  
  
  OBJECTIVE
  Our objective was to determine the efficacy of botulinum toxin injections in aesthetic reshaping of the lower face in Western populations and compare it to that in East Asian populations.
  
  
  METHODS
  Thirty-four Western patients (study group) had their masseteric muscles injected with botulinum toxin with an initial dose of 25 to 30 units on each side. This was compared to 48 East Asian patients (control group) who received an initial dose of 40 units on each side.
  
  
  RESULTS
  All patients achieved aesthetic improvement of the shape of their lower face, with an additional improvement in functional outcome attributed to bruxism in Western patients. There were few complications. The therapeutic dose for the Western population was lower than that for East Asian patients. In the Western population, aesthetic improvement lasted from 9 to 12 months, while the functional improvement from bruxism lasted for 6 to 7 months.
  
  
  CONCLUSIONS
  Botulinum toxin is effective in improving the aesthetic appearance of the lower face and the functional outcome in Western patients with masseteric hypertrophy.
authors.affiliation: steven@shapeclinic.com.au
authors.forename: Steven
authors.initials: S
authors.lastname: Liew
authors.forename: Andrea
authors.initials: A
authors.lastname: Dart
mesh_terms: D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002012:Bruxism / Q000150:complications*; D003357:Cosmetic Techniques / Q000009:adverse effects; D005060:Europe / Q000208:ethnology; D005202:Asia, Eastern / Q000208:ethnology; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000188:drug therapy / Q000209:etiology; D007273:Injections, Intramuscular; D008406:Masseter Muscle / Q000473:pathology*; D008875:Middle Aged; D009119:Muscle Contraction / Q000187:drug effects*; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A