ABOUT FACE

From very fancy lasers to bone-shaving surgery, there's no shortage of options when it comes to tweaking our jawlines. But as treatments become easier to obtain, should we be taking a harder look at the side effects?

- BY SAMANTHA HOLENDER

It was a regular Tuesday in August 2023 when Siena Gagliano made a split-second decision to change the shape of her jaw. A viral before-and-after video documenting an aesthetic treatment that took an influencer’s face from boxy and bulked-out to slim and heart-shaped had flashed across her screen. Forty-eight hours and $600 later, Gagliano and her numbed-up face sat in a medspa leather recliner, patiently awaiting the same procedure.

She didn’t view the neurotoxin injections she was about to receive in her jaw muscle (the masseter muscle, in official terms) as a Super Big Deal. Though none of the five available neurotoxins on the U.S. market—Botox, Xeomin, Jeuveau, Daxxify, and Dysport—are currently FDA-approved for use on the jaw, the 25-year-old writer had “heard so many good things” about the off-label treatment, which works by relaxing the overworked muscle and, in turn, slims down the area between the bone and skin.

At first, the treatment was a 10 out of 10. Gagliano’s side profile looked completely different, and she could feel the muscles getting flatter. “I had lost a little bit of weight, but have always had a square jaw, so I was really excited when the injections started to give me that Megan Fox, Bella Hadid slimmed jawline,” she says.

But fast-forward eight months, and her jaw didn’t look like that of an influencer on Instagram. Gagliano had jowls.

“Think of your jaw like a table and the skin like a tablecloth. If the table gets smaller—meaning that the muscle shrinks with Botox—and the tablecloth stays the same, you end up with a draping tablecloth,” says Michelle Henry, M.D., a board-certified dermatologist and founder of Skin & Aesthetic Surgery of Manhattan. It’s ironic, but when jawline injections don’t go according to plan, patients like Gagliano can end up with the antithesis of what they wanted.