In some patients, a really wide, round or “bottom-heavy” face can be attributed to overactivity of the chewing muscle or masseter muscle. As with any muscle, the more we use it, the bigger it gets. Excessive use, such as in patients prone to grinding or clenching their teeth, can lead to quite bulky masseter muscles, also referred to as “masseter hypertrophy”. However, many of these patients are completely unaware of any possible clenching or grinding, as this is often something we do in our sleep. Luckily a quick test during consultation can determine if you would be a suitable patient for this treatment. The way it works is we inject a relatively high dose of Botulinum Toxin into the muscle. Much in the same way we would when trying to relax a frown. Although in this case, we’re not targeting the movement, which we still need, we’re targeting the strength of the muscle. By bringing the muscle tension down to a slightly below average level, the muscle slowly starts to lose its volume, and the face will have a slimmer appearance.