Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Temporalis Reduction

Q. I have abnormally mild temporal convexity so my temporalis is misshapen and thick because of confinement of the muscle, I believe. Not sure if it’s overdeveloped. I ask: 1. How long would Botox keep the muscle smaller? 2. Would Botox for the temporalis have any effect on the masseter? 3. Can my temporalis–by surgical means–be reshaped to be normal?

A. ​Thanks for sharing your concerns.
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​Without further diagramming, and a complete evaluation of your face, it is most difficult to understand which part of your face/forehead you are describing as temporal convexity. The temporalis muscle is a bi-laminated muscle filling the temporal fossa in a “clam-shell” appearance under the zygomatic arch with its tendon at the hinge of the clamshell attaching to the coronoid process of the mandible.
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​In all the photos submitted, the widest aspect of your head is above the temporal muscle attachment where the parietal bone is attached to the temporal bone.
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​The premise of using Botox to the temporal muscle would therefore be ill advised for the following reasons:

• ​it would cause more concavity of the temporal hollow
• ​it would weaken one of the muscles used to close the mouth
• ​it would create a more aged appearance by shifting the widest facial projection downward

It would be best to be evaluated and advised by a Board Certified Plastic Surgeon or ENT talented in the use of injectables for this area.
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​I hope this is helpful. All the best!