Masseter Botox in Tokyo

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Masseter Botox — often called jaw Botox, jawline slimming or “square jaw” Botox — is the treatment international patients ask us for most. It relaxes the chewing muscle at the angle of the jaw, so the lower face gradually narrows and the clenching that many people do without noticing eases off.

Almond Clinic is a non-surgical aesthetic clinic in Ichigaya, central Tokyo, two minutes from Ichigaya Station. We publish our prices in full, and the price you see is the price you pay. Our staff assist you in English, and interpretation is arranged for the consultation with the doctor.

First: will Botox actually work on your jaw?

This is the question that matters, and it is the one most pages skip. A wide or square lower face has four different causes, and Botox only works on one of them.

What is causing it	Does Botox help?	How to recognise it
Muscle — an enlarged masseter	Yes — this is the one it treats	Clench your teeth hard. A firm lump bulges at the angle of the jaw and you can feel it move.
Bone — a wide mandibular angle	No	The outline stays exactly the same whether you clench or relax completely.
Fat	No	Soft and pinchable, and usually there is fullness under the chin and cheeks too.
Sagging	Very little	The jawline is blurred rather than square, and it looks different lying down.

The 10-second test you can do right now: put your fingers on the angle of your jaw, just in front of and below your earlobe, and bite down hard. If a solid lump pushes into your fingers, a good part of your jaw width is muscle — and that responds to Botox. If nothing much changes, it is unlikely to be.

Most people are a mixture. At your consultation the doctor will tell you honestly how much of your jaw width is muscle and what you can realistically expect — including when the answer is that this treatment is not the right one for you.

Before and after

Photographs of our own patients, taken about one month after treatment.

Treatment: masseter Botox injection.
What it does: a medicine that relaxes muscle movement is injected into the masseter, reducing the force of the muscle so that it gradually becomes smaller.
Side effects and risks: pain at the injection site, swelling, bruising, temporary difficulty chewing hard food, asymmetry, and a hollow look in the cheeks in slim faces.
Price: JPY 28,000 – JPY 60,000 (tax included; ultra-fine needle, sedation and the procedure are all included).
Doses shown: 80 units (first case) and 40 units (others). Photographs taken one month after treatment.
These are individual cases. Results, how quickly they appear and how long they last differ from person to person, and are not guaranteed. This is self-pay treatment, not covered by Japanese public insurance.

Price

	NABOTA	Botox Vista®
Standard dose (approx. 40 units)	JPY 28,000	JPY 40,000
Double dose (approx. 80 units)	JPY 38,000	JPY 60,000

Included in the price:

• The consultation with the doctor — no separate consultation or counselling fee
• The medicine and the injection
• A 34G ultra-fine needle — the finest gauge in common use, so it hurts far less
• Nitrous-oxide (laughing gas) sedation if you would like it
• Aftercare on LINE, in English, for as long as you need it

A touch-up within one month is charged at half the usual price (NABOTA). You can see every other Botox area and price here.

How many units, and how the change unfolds

The standard dose is about 40 units per side course, and about 80 units for a strongly developed muscle. The doctor decides after feeling the muscle while you clench, so the final number is set at your consultation rather than in advance.

The most important thing to understand is why it is not immediate. Botox does not dissolve or remove anything. It reduces how hard the muscle can contract; the muscle then gets less exercise, and a muscle that is used less becomes smaller. That takes weeks.

2–3 days	Your bite feels weaker. Nothing has changed in the mirror yet — this is the muscle relaxing, not shrinking.
2 weeks	The first hints of a softer outline. Clenching and night-time grinding usually ease around now.
1 month	The change in the face is normally visible. This is when we take the after photographs.
2–3 months	The fullest effect.
3–4 months	The effect fades gradually. Most people come back around here.
From the 2nd or 3rd round	The muscle has had less chance to rebuild, so the gap between treatments usually gets longer.

What to expect afterwards — including the part most clinics leave out

The usual, temporary things

• Hard food feels like more work for one to two weeks. Steak, chewy bread, dried squid. Ordinary meals are fine.
• Pain, small bruises or slight swelling at the injection points, settling within a few days.
• A hollow look in the cheeks in people who are already very slim in the face, because the masseter contributes some volume there. If this is your worry, we start with a smaller dose.
• Asymmetry. Almost everyone chews more on one side, so the two muscles are rarely equal to begin with. We check this before injecting and can use different amounts on each side.

The temples: something worth knowing before you start

Closing your jaw is not the masseter’s job alone — the temporalis, the fan-shaped muscle over your temple, shares the work. When the masseter is relaxed, the temporalis can take over part of the chewing force, and a muscle that is used more gradually develops.

So a small number of people find that, as the jaw narrows, the temples start to look fuller — the width of the face simply moves upwards. It is not a complication and it is not dangerous, but if you already have prominent temples or clench very hard, it is worth planning for.

The answer is to treat the two together rather than the masseter alone, so the chewing force is shared instead of pushed onto one muscle. Temple (temporalis) Botox is JPY 32,000 for about 40 units. We will tell you at the consultation whether this applies to you — for most people it does not.

When masseter Botox is not suitable

It is not suitable if you are pregnant, breastfeeding or planning to become pregnant, if you have a neuromuscular disease such as myasthenia gravis, or if you have had an allergic reaction to botulinum toxin. Tell the doctor about any medicines you take. If your jaw clicks, locks or is painful to open, say so — that is a joint problem and needs assessing separately.

If you are visiting Tokyo

Time needed	About 10 minutes for the injection. Allow around an hour in total for a first visit, including the consultation.
Downtime	None. Makeup straight away, sightseeing the same afternoon.
Flying	Not a problem. Avoid rubbing the area, hot baths and saunas, alcohol and hard exercise on the day.
Timing	Unlike forehead or frown lines, you will not see this one before you fly home. The change comes at about a month. Plan for it to arrive after your trip.
Booking	Message us on LINE as early as you can. We are appointment-only and weekends fill first.

Because the result appears well after you leave, we keep answering questions on LINE in English after you get home — send us a photo at one month if you want the doctor’s view on it.

Important information about unapproved medicines

Not approved in Japan. NABOTA, the Korean botulinum toxin type A product we use, has not been approved under Japan’s Pharmaceuticals and Medical Devices Act.

How we obtain it. It is imported by our physician under his own judgement, through the procedure set out in that Act (yakkan shoumei / import confirmation).

An approved equivalent exists in Japan. Botox Vista® (Allergan), which contains the same active ingredient, is approved in Japan and we offer it here. In August 2026 its Japanese package insert was revised to add masseter prominence in adults under 65, so treating the masseter with Botox Vista® is within its approved indications in Japan. (Package insert 4th edition, revised August 2026; approval numbers 22100AMX00398000 and 30800AMX00315000.) NABOTA is not approved in Japan and is not covered by this. See how the two products compare.

Safety information from other countries. NABOTA is approved by the Korean Ministry of Food and Drug Safety (MFDS) and by the U.S. Food and Drug Administration, where it is marketed as Jeuveau®. As a caution common to all botulinum toxin products, there have been reports of the effect spreading beyond the injection site, causing symptoms such as difficulty swallowing or breathing. If you have any such symptom, seek medical care immediately and contact us.

Relief system. Medicines obtained by personal import are outside the scope of Japan’s Adverse Drug Reaction Relief System. Masseter Botox is self-pay treatment, not covered by Japanese public insurance.

Who will treat you

Dr. Itsuki Nakayama — Director. Graduate of Juntendo University School of Medicine; trained at Juntendo University Hospital (general internal medicine, anaesthesiology, surgery) and studied at The Children’s Hospital at Westmead, Australia. Allergan-certified injector for Botox and hyaluronic acid.

Dr. Kenta Umeki — Technical Director. Graduate of Kindai University Faculty of Medicine; trained at Juntendo University Hospital (orthopaedic surgery, plastic surgery, anaesthesiology). Former director of a major aesthetic clinic. Allergan-certified injector for Botox and hyaluronic acid.

How to book — message us in English

Send us a photo of your jaw and tell us roughly when you are in Tokyo. Our staff will reply in English, give you a straight answer about whether Botox is likely to help in your case, and book the appointment for you. There is no obligation and you are welcome to ask about price first.

You can also call 03-5946-8027 during opening hours (10:00–18:00).

Frequently asked questions

How much is masseter Botox in Tokyo at your clinic?

JPY 28,000 for a standard dose of about 40 units, or JPY 38,000 for a double dose of about 80 units (NABOTA). With Botox Vista® it is JPY 40,000 and JPY 60,000. Tax, the consultation with the doctor, the medicine, our 34G ultra-fine needle, nitrous-oxide sedation and aftercare on LINE are all included. There is no separate consultation or injection fee.

How long until my jaw actually looks slimmer?

You will feel your bite weaken within 2 to 3 days, but that is the muscle relaxing, not shrinking. The muscle becomes smaller because it is used less, so the change in the outline of your face usually shows from about one month and is clearest at two to three months. If you want to see a result before you fly home, this is not a same-week treatment.

Will it work if my jaw is wide because of the bone?

No. Botox only acts on muscle. If the width comes from the jawbone, from fat, or from sagging, this treatment will not change it — and we will tell you so at the consultation rather than treat you anyway. There is a simple test you can do yourself: clench your teeth hard and feel the angle of your jaw. If a firm lump bulges out, the muscle is a major part of it.

How long does it last, and do I need to repeat it?

The effect fades over about 3 to 4 months, and most people come back at around that point. A useful thing to know: because the muscle has less chance to rebuild between treatments, the interval usually gets longer after the second or third round.

How many units will I need?

The doctor decides at your consultation, after feeling the muscle while you clench — the amount depends on how developed your masseter is, and that varies a lot from person to person. For reference, the dose range set out in Botox Vista®’s Japanese package insert for masseter prominence is 48–72 units, given at three points on each side. One thing worth knowing: units are specific to each product and cannot be converted between them, so “40 units” of one product and “40 units” of another do not mean the same thing.

Will it be hard to eat?

For the first one to two weeks, hard or chewy food (steak, dried squid, tough bread crusts) can feel like more work. Normal food is not a problem, and this settles as you adapt.

Can it make my cheeks look hollow?

It can, in people who are already very slim in the face, because the masseter contributes some volume there. If that is a risk for you, we start with a smaller dose rather than a full one. Tell the doctor if a hollow look is your main worry.

Does it help with clenching, grinding and jaw ache?

Often, yes. Many people who come to us for the shape of the face also grind their teeth at night or wake with a tight jaw, and reducing the force of the muscle usually eases that. It is not a treatment for a joint problem (TMJ disorder) — if your jaw clicks or locks, tell the doctor.

Is one side stronger than the other?

Very commonly, yes — most people chew more on one side. We check this before injecting and can use different amounts on each side. Perfect symmetry is not realistic, but a visible difference can usually be improved.

Can I have it done on a short trip to Tokyo?

Yes — the injection takes about 10 minutes, there is no downtime and you can wear makeup straight away. Just be realistic about timing: the visible change comes at around a month, so you will most likely see it after you get home. Message us on LINE in English and we will book it for you.

Do I need to speak Japanese?

No. Our reception and counselling staff assist you in English, and interpretation is arranged for the consultation with the doctor. The easiest way to start is to message us in English on LINE or WhatsApp — you can send a photo of your jaw and ask about price before you commit to anything.

Will masseter Botox give me jowls or make my face sag?

This is the question we are asked most, and the honest answer is: it depends on what your skin is already doing. The masseter sits deep and is not what holds your skin up, so reducing it does not by itself cause sagging — and because it removes width, the outline of the lower face usually looks tighter, not looser. Where it can matter is if you already have noticeable laxity. Taking volume out of a face that is already losing support can make existing looseness easier to see. If that applies to you the doctor will say so, start with a smaller dose rather than a full one, and talk to you about treating the neck (platysma) at the same time, which pulls the jawline in the other direction.

Are there long-term side effects if I keep having it?

Repeated treatment over years generally means the muscle stays smaller and the intervals get longer, which is the intended result. Two things to be aware of. Antibodies: with any botulinum toxin, long-term repeated use can lead the body to produce neutralising antibodies, and the treatment stops working. This is uncommon, and keeping at least three months between treatments reduces the risk — which is also what the package insert requires. Chewing: people who have had many rounds sometimes notice they tire more easily on very hard food. Neither is dangerous, and both reverse when treatment stops.

Is it permanent? What happens if I stop?

It is not permanent. The nerve endings recover, the muscle starts being used normally again and it gradually returns towards its original size — usually over several months after the last treatment. Nothing is damaged and nothing gets worse than before you started. Many people simply space treatments further and further apart rather than stopping outright.

Does masseter Botox help TMJ or jaw pain?

It often helps the muscle part of the problem. If your jaw aches from clenching, if you wake with a tight jaw or tender cheeks, reducing how hard the muscle can contract usually eases that, and many patients say this is the change they notice first. It is not a treatment for the joint itself. If your jaw clicks, locks, catches, or hurts when you open wide, that is a temporomandibular joint problem and needs to be assessed as one — tell the doctor at your consultation and be specific about the symptoms.

Does it stop teeth grinding at night?

It reduces the force, not the habit. Grinding is driven by the brain during sleep and Botox does not switch that off — but a muscle that cannot contract as hard does less damage to your teeth and produces less morning soreness. Many patients use it alongside a night guard rather than instead of one. If you grind heavily, tell the doctor; that usually points towards the higher dose.

How long does it last the first time? People say the first round is shorter.

That matches what we see. The first round often feels shorter than later ones — commonly around 3 to 4 months — because the muscle has had a lifetime of building up and returns to use quickly. From the second or third round the muscle has had less chance to rebuild between treatments, so the effect tends to hold longer and the gap between visits gets wider. Plan the first year as two to three treatments, then reassess.

Will my smile look different?

It should not, and avoiding that is part of the technique. The muscle that pulls the corner of the mouth outward when you smile (the risorius) sits close to the front edge of the masseter, and Japan’s package insert specifically instructs that it be avoided, along with the parotid gland. This is why the injection points are kept below a line from the corner of the mouth to the base of the ear, spaced about 1 cm apart and about 1 cm back from the front edge of the muscle. If too much spreads forward, the smile can look uneven for a few weeks until it wears off.

Does masseter Botox work for everyone?

No — and we would rather say so before you book. It works on muscle. If your jaw width comes from the shape of the jawbone, from fat, or from sagging, this treatment will not change it. Roughly speaking, if a firm lump pushes into your fingers when you clench hard, muscle is a significant part of your jaw width; if the outline barely changes between clenched and relaxed, it is not. Most people are a mixture, and the doctor will tell you honestly how much of yours is muscle.

I am a man — does it work the same way?

Yes, and the male masseter is often stronger, so a higher dose is more commonly appropriate. The case photograph at the top of this page is a male patient treated with approximately 80 units. Men also come to us for clenching and jaw ache as often as for the shape of the face.

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