Botox: Botox: Balancing Facial Aesthetics

By: Carly Fan

“I’m thinking about getting braces, Botox, or maybe something to reduce the fat under my chin, how do I make sure all these treatments work together to keep my face balanced and natural-looking?”

When people think of improving their smile or face shape, they often focus only on the teeth, but facial harmony also comes from understanding how dental, orthodontic, and cosmetic treatments interact with the whole face. Whether it’s deciding whether to extract teeth or expand the dental arch, using Botox to correct asymmetrical smiles, or reducing submental (under-chin) fat, it’s crucial that providers look beyond just one feature and take the entire facial aesthetic into account.

Orthodontics: Extraction vs. Expansion:

Orthodontic treatment goes a lot more beyond just straightening teeth, it’s also about shaping the entire lower facial profile. A key debate in orthodontics is whether to extract teeth (usually premolars) to create space or to expand the dental arch to accommodate crowded teeth. These choices also affect the fullness or flatness of the lips and midface, as well as the side profile and chin projectionong-term stability of the bite and jaw position

Over-extraction or missing teeth can sometimes lead to a flatter facial profile, sunken cheeks, or thinner lips, which may not align with the patient’s desired aesthetic (Kim et al., 2019). On the other hand, aggressive expansion without clear anatomical room can strain the gums and bone. A skilled orthodontist must balance occlusion (how the teeth fit together) with how changes will affect the entire facial appearance, not just the dental arch

Botox for Smile and Lip Control

Botox, often thought of for forehead wrinkles, has become an effective tool for fine-tuning lower-face aesthetics. Injecting Botox around the mouth can:

• Soften a gummy smile by relaxing the muscles that pull up the upper lip

• Reduce asymmetry in cases of crooked smiles or uneven lip movement

• Smooth perioral lines (“smoker’s lines”) around the lips

• Relax overactive chin muscles that cause dimpling or an inverted “V” chin shape

Botox works by temporarily paralyzing small facial muscles, allowing the overlying skin and tissues to settle into a smoother or more balanced position (Rzany & DeLorenzi, 2015). However, there are also cases where orthodontic treatment, like pushing the arch out more, can replace the need for botox as it could give the face a “fuller” appearance.

Melting the Fat Under the Chin

Submental fullness, or fat under the chin, can make people feel self-conscious, even if they’re at a healthy weight. Non-surgical treatments like deoxycholic acid injections (Kybella) can break down fat cells under the chin, improving jawline contour (Suh et al., 2016). Alternatively, small-scale liposuction procedures can also target this area for faster results.

For optimal results, be sure to consult your dentist regarding your skin elasticity (to avoid loose skin afterward), as they will also take into account your jawline bone structure. While the results may be aesthetically pleasing, there are risks because reducing under-chin fat without considering these factors may leave patients with uneven results or unexpected sagging.

Overall, whether you’re undergoing orthodontic changes, Botox, or chin contouring, the aesthetic understanding of your provider matters as much as their technical skill. A dentist or orthodontist must understand how tooth movements affect lip support and facial contours. A Botox injector must respect the dynamic nature of the face, not just treat static wrinkles. And chin fat treatments should be tailored to the patient’s full facial profile, not just target a pocket of fat. Talking to your dentist, and not having just isolated fixes, is essential for safe, natural, and beautiful results that satisfy you the most.