Botulinum toxin A injection for masseter reduction is generally considered minimally invasive, safe, and effective.

However, this approach may lead to facial flaccidity and sagging, especially in older patients with reduced elasticity of the skin and the soft tissue.

The authors analyzed 27 cases of patients who presented with the above complications and treated them with botulinum toxin A injections into the platysma and the depressor anguli oris muscle.

The efficacy of treatment was evaluated by both patients and physicians.