Botox vs. Contour Injection,

Why the Difference Comes Down to a 13 mm Masseter

Last Wednesday,

a woman in her early 30s came into the clinic.

"My jaw looks square, so I'd like to get a contour injection"

she said.

But when I examined her, her masseter muscle was

very firmly palpable.

That was why she saw little difference even after

getting contour injections twice.

Let me walk you through why this happens, step by step.

Botox and contour injections,

are placed in the same area, but the medications are different

Botox is an injection that blocks the signal

from the nerve to the muscle.

It temporarily prevents the muscle from moving,

reducing its volume.

A contour injection breaks down the cell membrane

of fat cells to dissolve fat.

The key is reducing subcutaneous fat,

not muscle.

If Botox is a 'muscle OFF switch,'

the contour injection is a 'fat breaker.'

Why Botox for some people,

and contour injections for others?

"For jawline refinement, if the muscle is thick, choose Botox,

if the fat is thick, choose a contour injection.

If ultrasound shows the masseter is over 13 mm, start with Botox,

if subcutaneous fat is over 10 mm,

start with a contour injection. That is the safest way to avoid disappointment."

— Dr. Wi Young-jin (Hongdae Beautystone Clinic)

Getting a procedure without even knowing what suits

you is the number one reason it fails.

For some people, the masseter has developed because

they sleep with their teeth clenched,

while others simply have a constitutionally thicker layer of

facial subcutaneous fat.

In the clinic, I measure the numbers

directly with ultrasound.

If the muscle is over 13 mm and you only dissolve fat,

you can't create a defined line.

The client who suspected Botox resistance was actually a case where

the subcutaneous fat measured 12 mm,

so the contour injection was the right answer.

Botox and Contour Injection,

How to Choose the Right Option for You

I've organized it into a table for easier reading.

Botox must be placed precisely in the masseter only

so your expression doesn't look unnatural.

With a contour injection, accurately matching the depth of the fat layer

is the key to preventing side effects.

The approach must differ by layer—under the chin, cheek fat, and

deep fat all require different strategies.

The Three Questions I Hear Most Often in the Clinic

Q1. Is it more effective to get both procedures together?

If both muscle and fat are thick in a 'combined type,'

then combining them makes sense.

But if only one side is the problem,

there's no need to spend twice as much.

I usually treat one issue first and

decide after checking the progress a month later.

Q2. Do I have to get Botox for the rest of my life?

Is a contour injection really semi-permanent?

If you stop Botox, the muscle becomes thick again.

However, if you keep up treatment consistently for about 3 years,

the muscle may atrophy and the interval can become longer.

A contour injection removes the fat itself, so

that area doesn't fill back in,

but if you gain a lot of weight, other areas can

thicken, so ongoing management is important.

Q3. Will my face sag after the procedure?

As the muscle or fat that supported the volume decreases,

some sagging can occur.

For people with reduced skin elasticity, combining it with a lifting treatment

is much safer in the long run

than doing the procedure alone.

If you take away just one thing today

— don't choose the procedure name first for the jawline,

measure the masseter and fat thickness first.

13 mm and 10 mm are the clearest decision points.

In the next post,

I'll explain the timing for repeat Botox when the

masseter exceeds 13 mm.

This is Dr. Wi Young-jin.

Frequently asked questions

Q. Is it more effective if the two treatments are done together?

A. If it’s a “combined type” with both thick muscle and fat, treating them together is the right approach.

Q. Do you need to keep getting Botox for life? Are contour injections really semi-permanent?

A. If you stop Botox, the muscle gradually thickens again. Contouring injections remove fat cells entirely, so that area does not fill back up; however, if you gain a significant amount of weight, other areas may become thicker, so ongoing management is important.

Q. Will my face sag after the procedure?

A. As the muscle or fat that supported the volume diminishes, sagging may occur.

Q. How do I decide between getting Botox or contouring injections?

A. It is most accurate to determine the treatment plan by measuring the thickness of the masseter muscle and subcutaneous fat using ultrasound. If the masseter muscle is over 13mm, it is best to start with Botox. If the subcutaneous fat is over 10mm, starting with contouring injections first will minimize the chance of treatment failure.