What each procedure addresses
Buccal fat removal reduces volume in the mid-to-lower cheek area. It addresses fullness between the cheekbone and jaw, in the soft tissue of the cheek. The effect is permanent. Best results are in young patients with round faces.
Masseter Botox partially relaxes the masseter muscle (the chewing muscle at the jaw angle). Over 8–12 weeks, the muscle gradually shrinks, narrowing the jaw width. The effect is temporary (lasts 4–6 months initially, longer with repeated treatments). Best results are in patients with prominent masseter muscle activity, often associated with bruxism (teeth grinding).
The two procedures act on different anatomy and don't overlap.
Why combine them
Many patients seeking lower-face slimming have both mid-cheek fullness and jaw width. Doing buccal fat removal alone can produce an "underwhelming" result if the jaw was the main driver. Doing masseter Botox alone leaves the cheek unchanged.
The combination:
- Slims the mid-cheek (buccal fat) AND narrows the jaw (Botox)
- Reveals a more sculpted jawline transition
- Often gives patients the "facial slimming" result they were imagining
- Reduces the risk of regret from over-removing buccal fat (because the jaw reduction does part of the slimming work)
Timing options
Option A: Botox first, then surgery (recommended). Get masseter Botox at home or at our clinic, see the jaw-width result at 12 weeks, then decide on buccal fat removal based on whether you still want further cheek slimming. This approach lets you "preview" half the result before committing to the permanent half.
Option B: Same day. Both procedures during your Istanbul visit. Reasonable for patients already clear on their plan. Buccal fat is performed in theatre; masseter Botox is administered in clinic on the same day or the day after.
Option C: Surgery first, then Botox at 3-month review. See the buccal fat result first, then add masseter Botox if you want further slimming. Less common, used when the jaw width is borderline.
Who should NOT combine
- Patients with already-narrow jaw and no masseter prominence — combination would over-slim
- Patients with significant temporomandibular joint (TMJ) problems — masseter Botox can worsen some TMJ cases
- Patients planning pregnancy — Botox should not be used during pregnancy
- Patients on certain medications affecting nerve-muscle function
Practical notes
If you combine procedures during your Istanbul visit:
- The masseter Botox part takes 5 minutes and is essentially painless (very fine needle injections)
- It can be administered before or after the buccal fat surgery — both work
- The Botox effect develops slowly over 4–12 weeks, so don't expect immediate jaw narrowing
- Cost is added to your overall package
- Follow-up care is essentially the same as for buccal fat alone
Frequently asked questions
How long does masseter Botox last?
First treatment: 4–6 months. With repeat treatments every 4–6 months over 1–2 years, many patients find the effect lasts longer between sessions and can space treatments to 6–9 months.
Can I get just the masseter Botox without buccal fat surgery?
Of course. Many of our patients get masseter Botox alone and never proceed to buccal fat. It's a reasonable starting point because it's non-permanent and reveals whether jaw narrowing alone gives the result you want.
Is masseter Botox safe?
Yes, when administered correctly. It's been in widespread aesthetic and dental use for over 20 years. Side effects are typically minor and temporary (mild tenderness, occasional asymmetric smile that resolves within weeks).
Not sure if you're a candidate?
Buccal fat pad removal is the right choice only for the right face. Send 3 facial photos (front, profile, three-quarter) and Doç. Dr. Erdal will give you an honest, no-pressure suitability assessment before you decide anything.
Ready to discuss buccal fat removal?
Schedule a free WhatsApp consultation with Doç. Dr. Erdal. Send a few facial photos and your questions — typical response within 2 hours during business hours.