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Updated: Feb 19, 2026

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Does Botulinum Toxin Injection into Masseter Muscles Affect Subcutaneous Thickness?

Gunwoo Park1, Young-Chan Choi1, Jung-Hee Bae1

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Summary

Botulinum toxin (BoNT) injections for masseter muscle hypertrophy primarily affect muscle thickness, not subcutaneous thickness. This study used ultrasonography to confirm BoNT

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Area of Science:

  • Plastic Surgery
  • Dermatology
  • Medical Imaging

Background:

  • Botulinum toxin (BoNT) is a common treatment for masseter muscle hypertrophy.
  • Previous studies focused on muscle thickness changes, neglecting subcutaneous layer variations.
  • No research has quantified changes in skin-to-masseter muscle thickness post-BoNT.

Purpose of the Study:

  • To evaluate ultrasonographic changes in both masseter muscle and subcutaneous thickness after BoNT injection.
  • To differentiate the effects of BoNT on muscle versus overlying soft tissues.

Main Methods:

  • A prospective study involving 20 volunteers divided into BoNT and saline control groups.
  • Ultrasonography measured muscle and subcutaneous thicknesses at baseline and 4, 8, 12 weeks.
  • Measurements were taken at rest and during maximum muscle contraction.

Main Results:

  • Subcutaneous thickness showed no significant changes over time or between groups.
  • Masseter muscle thickness significantly decreased in the experimental group over the study period.
  • No significant differences in subcutaneous thickness were observed, regardless of muscle state or group.

Conclusions:

  • Botulinum toxin injections effectively reduce masseter muscle thickness.
  • Subcutaneous tissue thickness remains unaffected by botulinum toxin treatment for masseter hypertrophy.
  • Ultrasonography is a reliable tool for assessing these specific tissue changes.