MD Asian Jawline Exploring Current Injectable Treatment Strategies in the Asian Face

In many East Asian societies, beauty holds immense value, as it impacts one’s social standing, career opportunities, and educational growth. The proverb, “Your face is your rice bowl,” summarizes the ever-increasing demand for aesthetic interventions, specifically among younger generations.1

While the global aesthetic industry flourishes, exceeding 18.8 million non-surgical procedures in 2022 alone, Asia (specifically East Asia) is projected to become the fastest-growing region by 2027.2 Cultural factors, economic prosperity, and accessibility shape patient expectations and motivations for seeking the coveted ‘Asian jawline.’

But this market thrives not on mere imitation but on innovation. Today, healthcare professionals are embracing specialized techniques tailored to distinct Asian facial features and differences in their aesthetic preferences. Procedures such as “Asian jaw BOTOX®” and “Asian blepharoplasty” offer culturally sensitive solutions that enhance natural beauty rather than simply replicating Western ideals.

Key Takeaways

  • Unique Facial Features: Asian faces have distinct characteristics, such as low nasal bridges and broader structures.
  • Cultural Diversity: Asians are a heterogeneous population that can significantly influence aesthetic preferences. Hence, it is essential to acknowledge the diversity.
  • Skin and Aging: Familiarizing with the thickness and susceptibility of Asian skin to hyperpigmentation, which allows the opportunity to offer tailor-made treatments. 
  • Personalized Approach: To prioritize ethnic identity and customize aesthetic treatments for natural enhancement.
  • Harmony and Balance: Naturalness and balance form the backbone of Asian beauty ideals.
  • Ongoing Innovation: To improve the scope of future advancements in aesthetic medicine to accommodate diverse facial characteristics and skin types.

Understanding the Asian Facial Features

Using conventional treatment recommendations tailored to Western populations in Asian patients may lead to unnatural-looking results due to variations in the anatomy and skin biology of the two groups. 

Here is a table depicting the anatomic features of the Asian vs. Western face:1,3

MD Tabela2

While aging is inevitable, it manifests differently across ethnicities.1 Understanding these variations is essential to providing effective and culturally sensitive care.

Asians’ skin aging changes

 

  • Delayed onset: Persistence of babyfaces (facial neoteny) and thicker dermis may delay wrinkles, but deeper ones may appear later.
  • Skin: Dense pigmentation offers protection. Additionally, deep wrinkles form in the perioral and periorbital areas.
  • Fat: Wrinkles may be delayed by dense midface fat, but sagging occurs later.
  • Bone: The midface contour and inferior orbital rim are impacted by resorption.
  • Morphology: Subtle shifts in facial dimension.

Caucasians’ skin aging changes

 

  • Early onset: More likely to experience rhytids, laxity, and ptosis earlier, which get more pronounced with time. 
  • Skin: Increased susceptibility to pigmentation, severe wrinkles, and sagging, especially in the lower face.
  • Fat: Volume loss and sagging can be seen.
  • Bone: Greater changes contribute to facial sagging.
  • Morphology: Perioral laxity and lip changes similar to Asians. 

Patient Evaluation

Advanced injection techniques require experienced clinicians with a deep understanding of anatomy and its variations to avoid potential complications and ensure patient satisfaction.

A successful cosmetic procedure is incomplete without a meticulous evaluation process. This involves analyzing parameters such as facial form, function, symmetry, and proportions. These are typically executed using direct examination, 2D/3D photos, and standardized head positions. Including psychological, social, and cosmetic factors while noting medical history aids in identifying potential concerns like body dysmorphic disorder (BDD) and guides appropriate treatment choices.

In addition, soft tissue landmarks, subunit, and facial analysis techniques are useful in scrutinizing specific features and proportions. Vertical and oblique/lateral views complement the evaluation process by providing insights into asymmetry and profile balance. 

Many individuals of Asian descent often desire a more slender jawline, popularly known as the “V-line” or “V-shaped face. Interestingly, when it comes to a square jaw vs. a round jaw, an online survey among the Chinese (Han) population revealed that a strong mandibular angle tends to portray the square jaw as ‘unattractive’ to the majority of the Asian population. In contrast, softer contours in the round jaw lend a fuller and more youthful impression to the face. The V-shaped jawline creates a smoother outline while gently tapering down towards the chin (without sharp angles). 

How to Get an Asian Jawline? Some Injectable Treatment Options

A common concern among Asians is a wide jawline characterized by submental fullness, jowling, or loss of definition.

BOTOX® 

 

The main focus of BOTOX® type A (BoNT-A) use is to address skin quality, face, and body shape (such as contouring the shoulders, calf, and jawline).4 BOTULAX®, a Korean brand of BOTOX® for jawline reshaping, is gaining popularity for its safety profile and wide-ranging benefits. It can be injected into the masseter muscles to reduce their bulk to create a slimmer jawline. It also targets the mentalis muscle, effectively reducing chin dimpling and achieving a transformative v-line chin slimming effect. Additionally, it is potent in reshaping the lower face and harmonizing facial contours for a more aesthetically pleasing profile.

Strategically injecting BOTOX® (BoNT-A) in patients with enlarged masseter muscles (that contribute to a broader jawline) can induce “facial slimming” by relaxing these muscles.  Additionally, targeting the submandibular gland with these injections with these injections can offer some relief from submental fullness. Furthermore, injecting the pre-platysma muscle with BoNT-A helps counter laxity and refine jawline definition.

Delivering tiny amounts of BOTOX® to the entire face and neck improves skin texture and minimizes fine lines and wrinkles. This technique stimulates collagen production, which ultimately tightens and enhances the skin’s overall quality. CaHa-based fillers (RADIESSE®) can also be a valuable addition to improve skin laxity in the lower third of the face. 

Along with BoNT-A, additional techniques, such as injecting Deoxycholic acid (DCA) and microtoxin, show promise in improving jawline contour. DCA effectively targets localized fat deposits in the submental area and jowls, whereas microtoxin application (approx. 5–7 cc/100 U of onabotulinum toxin A or incobotulinum toxin A) uses BoNT-A in microdoses to control glandular activity, target dynamic lines, and improve skin quality. 

Combining BoNT-A with microtoxins can subtly lift and elongate the mandible while minimizing potential side effects associated with deeper injections.

Irrespective of the technique used, having a holistic understanding of each approach’s potential risks and benefits can help prevent undue complications. For example, in the case of DCA, the correct injection technique is vital to protecting the marginal mandibular nerve. Similarly, using conservative BoNT-A doses is advisable for masseter enlargement in younger patients to prevent potential concerns like bone resorption or sunken cheeks.

Dermal Fillers

 

Hyaluronic acid (HA) fillers are the go-to option among various filler materials in Asian facial aesthetics. These fillers can enhance facial contours and address volume loss to achieve natural-looking results. Here is an overview of how HA-fillers are used in Asian patients for cosmetic purposes:

Volume Restoration and Enhancement: HA-based fillers restore volume loss in the cheeks, temples, and under-eye hollows to improve facial symmetry and enhance youthfulness. Strategically injecting hyaluronic acid fillers into specific facial regions can enhance facial contours, lift sagging tissues, and provide structural support for a balanced and harmonious facial profile.

Midface Volumization: Midface volumization is a cosmetic treatment that uses HA fillers to add volume to the cheeks and under-eye area. This can effectively counter volume loss in the infraorbital and mid-cheek region to create a rejuvenated midface. 

Chin Augmentation and ContouringIn Asians, chin fillers are typically used to improve chin projection, symmetry, or hypoplasia. In the hands of an expert cosmetic specialist, this procedure can fashion a more defined jawline and harmonize facial proportions. When combined with BOTOX®, fillers (0.2–1 cc) can help address overactivity of the mentalis muscle and create a balanced lower face.

Lip Enhancement and Reshaping: Unlike Western patients, Asians usually opt for lip fillers to improve definition, create a more balanced lip shape, and subtly enhance existing facial features. 

Facial Rejuvenation and Anti-Aging: Volume loss and structural deficiencies are top contributors to facial aging. Placing fillers tactically in these deficient areas helps soften wrinkles and folds while optimizing facial contours for a naturally refreshed look.

Enhancement with Asian Jawline Surgery 

Unlike Western cultures, facial skeletal contouring among Asians favors reduction and refinement. As a consequence, different facial skeletal reduction techniques have been developed by East Asian surgeons to suit the needs of this particular demographic. However, these techniques can serve anyone looking to correct their jawline symmetry, refine chin size, or reduce facial width, irrespective of ethnicity. 

Among Asians, chin implants are a sought-after cosmetic procedure to augment the chin’s projection to shape a proportionate facial profile. A silicone implant is inserted into the chin to improve its size and shape. The result is a defined jawline with enhanced projection, creating an aesthetically pleasing appearance. 

Additionally, jawline reduction surgery involves reducing the mandible’s width to fashion a more slender and V-shaped jawline. Cosmetic surgeons use Asian facial skeletal contouring surgery to: correct jawline asymmetry, reduce facial width, and refine chin size. 

Minimally invasive procedures like Zygomatic Reduction, V-Line Surgery, Mandibular Angleplasty, and Sagittal Osteotomy can help achieve the ideal facial contour by imparting a more delicate and feminine shape. 

However, before considering facial contouring surgery, it is important to prioritize realistic expectations and safety for successful outcomes.

Conclusion

Asian patients often have distinct facial aesthetic goals (e.g. achieving the perfect Asian jawline) compared to their Western counterparts. The true focus lies in enhancing natural features and proportions to create a harmonious and distinctly Asian appearance. Lengthening the midface and forehead for balance while subtly narrowing the lower face can help achieve the desired oval form. The key to responsible and personalized practices is to balance an individual’s unique concerns and the influence of prevailing cultural trends. 

FAQs

 

What type of jawline is most attractive?

The perception of beauty can be subjective. However, The perception of attractiveness is similar across different cultures. A defined, symmetrical structure with harmonious proportions characterizes the ideal jawline. This creates an overall sense of balance. 

Can jaw BOTOX® go wrong?

As with any medical procedure, risks with jaw BOTOX® exist. Potential complications include bruising, swelling, pain, asymmetry, and rarely, allergic reactions or nerve damage. A thorough risk assessment by a certified dermatologist or cosmetic surgeon ensures safe and effective injection techniques with minimal chances of adverse events. 

How long does jawline BOTOX® last?

The effectiveness of jawline BOTOX® usually lasts between 3 and 6 months and can be affected by factors such as metabolism and muscle activity. It is recommended to have regular check-ins with a qualified healthcare provider to receive timely reinjection, which can help maintain optimal and long-lasting results and patient satisfaction. 

How much BOTOX®® is needed for the jawline?

Regarding the appropriate dose of BOTOX® for the jawline treatment, factors such as muscle mass, desired aesthetic outcome, and patient tolerance has a significant say. Generally, the dosage (for the masseter muscle) in a v-line BOTOX® procedure ranges from 15 to 50 units per side. The adjustments are made based on anatomical variations and treatment goals.

References

 

  1. Samizadeh S. (Ed.). Non-Surgical Rejuvenation of Asian Faces. Springer Cham; 2022. DOI: https://doi.org/10.1007/978-3-030-84099-0
  2. Kwon SH, Lao WW, Lee CH, Hsu AT, Koide S, Chen HY, Cho KH, Tanaka E, Cheon YW, Chang TN. Experiences and attitudes toward aesthetic procedures in East Asia: a cross-sectional survey of five geographical regions. Arch Plast Surg. 2021 Nov;48(6):660-669. doi: 10.5999/aps.2020.02565. Epub 2021 Nov 15. PMID: 34818714; PMCID: PMC8627936.
  3. Y. Gao, J. Niddam, W. Noel, B. Hersant, J.P. Meningaud, Comparison of aesthetic facial criteria between Caucasian and East Asian female populations: An esthetic surgeon’s perspective, Asian Journal of Surgery, Volume 41, Issue 1, 2018, Pages 4-11, ISSN 1015-9584, https://doi.org/10.1016/j.asjsur.2016.07.007.
  4. Fabi SG, Park J-Y, Ho WWS, Vachiramon V, Dayan S. Aesthetic considerations for treating the Asian patient: Thriving in diversity international roundtable series. J Cosmet Dermatol. 2023; 22: 1805-1813. doi:10.1111/jocd.15787
  5. Wu, W.T.L., Liew, S., Chan, H.H. et al. Consensus on Current Injectable Treatment Strategies in the Asian Face. Aesth Plast Surg 40, 202–214 (2016). https://doi.org/10.1007/s00266-016-0608-y