If your lower face still looks wide after masseter Botox, or you have read about salivary gland Botox online, the first question is not which product or how many units. It is what is actually making your jawline look wide. Masseter Botox shrinks the chewing muscle at the corner of the jaw. Salivary gland Botox goes into the parotid glands below the ears or the submandibular glands under the jawbone to reduce the volume of saliva-making tissue. It only makes sense when a gland is what stands out. This guide explains how to tell the difference, what the research shows, the side effects and the off-label status in Korea, with answers from Dr. Park Hwonham, Medical Director of Kondae PPEUM Clinic in Seoul and a surgeon trained at Seoul National University Hospital. This is a treatment guide: we do not have patient photos for this treatment.
Salivary gland Botox at a glance
- Who it is for: a soft bulge below the earlobe that does not harden when you clench (parotid), or a separate lump you can feel under the jawbone (submandibular), that makes the jawline look heavy
- Who should skip it: people whose glands do not stand out. It brings little change and can cause dry mouth instead. A square jaw from the masseter, fat under the chin or a gland that has sagged with age may also change little
- When it shows: gradually, over the following weeks to months; studies measured the change at three and six months, and data on when it starts is limited
- How long it lasts: in practice the effect is usually seen as wearing off over about six months; cosmetic data on duration is still limited and results vary
- Main risks: dry mouth (rare in practice) and, rarely, difficulty swallowing. In Korea, no toxin product is approved for the salivary glands, so cosmetic gland injections are off-label
Is It Your Salivary Glands, the Masseter or Fat?
A heavy-looking lower face can come from the salivary glands, the chewing muscle, fat, sagging, or a mix of these. Salivary gland Botox only matters when a gland actually stands out. Dr. Park starts every consultation with a simple check that you can partly try in front of a mirror:
| If it looks like this | Look first at | What usually fits |
|---|---|---|
| A firm, large bulge appears when you clench your back teeth | Muscle (masseter) | Masseter Botox |
| The area below the earlobe bulges even with your face relaxed | Enlarged salivary gland | Salivary gland Botox |
| The whole jawline is simply not well defined | Body fat | Weight and fat management |
In more detail, these are the signs a doctor looks for:
- Likely the glands: a soft swelling below the ear that does not harden when you clench (parotid), or a separate lump you can feel below the jawbone (submandibular).
- Likely the muscle: the corner of the jaw below the ear bulges firmly when you clench. Here masseter Botox is the first thing to consider (see our masseter Botox in Korea guide).
- Likely fat: no separate gland can be felt and the whole area under the chin is full. Toxin reduces saliva-making tissue but does not reduce fat. Fat under the chin is a different question (see double chin treatment in Korea).
- Likely sagging: fullness under the jaw that came with age. In an analysis of 100 CT scans, the submandibular gland descended below the jawbone by an average of 0.17 mm a year, while its volume did not change with age. It sagged rather than grew, so even if toxin reduces its volume, toxin cannot lift the gland.
Body shape plays a part too. In an ultrasound study of 214 people, a higher body mass index (BMI) went with a submandibular gland that sat deeper under the skin and further from the jawbone. That is why looking in the mirror is often not enough. A 2026 review also noted that the submandibular gland can look less prominent when you lie down, so it is assessed upright. A proper consultation includes feeling the area, asking you to clench, and, where needed, checking with ultrasound.
Salivary Gland Botox vs Masseter Botox
Both use the same kind of drug, but they aim at different tissue. That is why one can work well for a friend and change little for you.
| Masseter (jaw) Botox | Salivary gland Botox | |
|---|---|---|
| Where it goes | The masseter (chewing muscle) | The parotid and/or submandibular glands |
| What it reduces | Muscle volume | Volume of saliva-making tissue |
| How the area feels | Hardens when you clench your teeth | Does not harden when you clench |
| Korean MFDS approval | Nabota is approved for benign masseter hypertrophy | No product found with a salivary gland indication |
| Side effects to know | Discomfort when chewing, hollow cheeks, facial asymmetry and, rarely, dry mouth | Dry mouth and, rarely, difficulty swallowing |
A 2026 review explained that the parotid does not harden when you clench and feels soft, which tells it apart from the masseter, which does harden. The same review noted that when the side of the face still looks wide after masseter Botox, the parotid may be the cause. The reverse is also true: if the width comes from the masseter, injecting only the glands changes little. When both contribute, both are sometimes treated, and then the combined dose and the interval for both areas need to be checked (more on this below).
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How Parotid and Submandibular Gland Botox Work
Like muscles, salivary glands need a signal from the nerves (acetylcholine) to make saliva. When botulinum toxin blocks that signal, the saliva-making tissue works less, and over time the gland’s volume decreases. It is the same principle used to reduce saliva in people with severe drooling. In the US and Europe, Xeomin (incobotulinumtoxinA) is approved for chronic sialorrhea (drooling), according to 2023 German interdisciplinary practice recommendations.
| Gland | Where it sits | How it shows on the jawline |
|---|---|---|
| Parotid gland | In front of and below the ear, above the jaw angle | The area below the earlobe looks swollen and the side of the face looks wide |
| Submandibular gland | Under and inside the jawbone | Fullness below the jawline blurs the border between jaw and neck |
What the research shows
- Parotid, cosmetic study: in a randomised study of 30 people who wanted a slimmer face, split into high-dose, low-dose and placebo groups with toxin injected into both parotid glands, both treated groups had a significantly larger reduction in parotid volume than placebo. After three months, volume recovery was 7.6% in the high-dose group and 4.8% in the low-dose group.
- Parotid hypertrophy: in a prospective study of 36 people with benign parotid hypertrophy (33 completed), the thickness of the superficial part of the parotid fell significantly at six months of follow-up and facial contour improved. How severe the hypertrophy was affected the result. There were no serious adverse events.
- Submandibular gland Botox: a German university hospital ENT group gave 23 people with bilateral submandibular gland hypertrophy a single ultrasound-guided injection of 15 units and reported no major complications over 18 months. There are no large comparative studies yet.
- Drooling studies: in a randomised study of 184 people with drooling (SIAXI), the group given 100 units of Xeomin produced significantly less saliva than placebo at week 4, and the effect lasted to week 16. A meta-analysis of 17 randomised drooling studies (981 people) found that botulinum toxin reduced drooling at week 4.
These are small studies, and the drooling studies involved different patients, purposes and doses. A 2026 dosing review said the evidence for cosmetic doses in the salivary glands is still limited, and that glands should be assessed separately from muscles. Results vary between people.
When Salivary Gland Botox Shows and How Long It Lasts
Few studies have formally measured when cosmetic salivary gland Botox starts to work and how long it lasts. Right after the injection the face shape is unchanged; the gland's volume decreases over the following weeks to months. What has been measured so far:
| Study | Finding |
|---|---|
| Parotid randomised study (30 people) | 4.8–7.6% of the reduced volume came back after three months |
| Parotid hypertrophy prospective study (33 completed) | Thinner parotid at six months of follow-up |
| Drooling randomised study (184 people) | Less saliva at week 4, effect lasting to week 16 |
Before
About 3 monthsThe drooling result cannot be read as the duration of a cosmetic result. How long it lasts depends on the size of the gland, the amount injected and whether the toxin went precisely into the gland.
How often it is repeated
In practice, about six months is usually seen as the cycle over which the effect wears off, and a three-month interval is sometimes recommended to reduce the glands' function more actively. Because the glands are not an approved site, the approval information sets no interval for them. Even for approved areas, Korea's MFDS approval information states that the safety of frequent injections has not been established, and Xeomin's Korean approval information says frown-line treatments should be at least three months apart. If you also have jaw Botox, check the combined amount and the interval for both areas with your doctor. Short intervals and high total doses are discussed as resistance risk factors in our article on why Botox can stop working.
Submandibular Gland Botox Side Effects and Off-Label Status in Korea
Before the side effects, the plain regulatory fact: Korea's MFDS approval information for the five toxin products most used in Korea (Botox, Xeomin, Nabota, Botulax and Coretox; checked on Drug Safety Nara in November 2026) lists no indication related to salivary glands or drooling. Cosmetic indications are frown lines, crow's feet and forehead lines, and for the jaw, Nabota is approved for benign masseter hypertrophy. Cosmetic salivary gland injections are therefore off-label, done at the doctor's judgement. No treatment is free of side effects; these are the ones to know:
- Dry mouth: the other salivary glands make up for it, so a truly dry mouth is very rare in practice. Still, a 2026 review stated that about two-thirds of resting saliva comes from the submandibular glands, so a dry feeling can follow submandibular injections, while it is rare after parotid injections. In the SIAXI drooling study, dry mouth was 5.4% at 75 units and 2.7% at 100 units, but those patients had too much saliva to begin with. The review said these rates cannot be transferred to cosmetic treatment, and no study has measured dry mouth after cosmetic treatment.
- Difficulty swallowing: in SIAXI it was 2.7% at 75 units and 0% at 100 units. In a Korean case report, a healthy 37-year-old woman developed severe difficulty swallowing, including silent aspiration, the day after receiving 20 units of Xeomin into each submandibular gland without ultrasound. She recovered fully after five months of rehabilitation.
- Warnings in the approval information: the MFDS approval information states that serious adverse events, including fatal outcomes, have been reported when botulinum toxin was injected into the salivary glands, the oro-lingual-pharyngeal region, the oesophagus or the stomach. Some of those patients already had swallowing difficulty or weakness, and safety and efficacy for indications involving these areas have not been established.
- Common reactions: in the drooling meta-analysis, adverse events were mostly mild to moderate and resolved on their own.
Get medical care right away if
- swallowing water or food is hard, or you often choke when drinking
- your voice changes or your speech becomes slurred
- breathing is hard
Tell the clinic first if swallowing is already uncomfortable or your mouth is often dry, you have had inflammation or stones in a salivary gland, you have a nerve or muscle disease such as myasthenia gravis, you are pregnant or breastfeeding, or you recently had Botox in another area (jaw, forehead and so on). Whether to treat, and how much, may change.
Why Ultrasound Guidance Is Used
- Finding the cause: sitting up, the doctor feels the area and asks you to clench to tell glands, muscle and fat apart. The submandibular gland can look less prominent lying down, so it is assessed upright where possible.
- Finding the position: gland size and depth differ between people. In the 214-person ultrasound study, the submandibular gland was almond-shaped, averaging 33.7 mm long, 13.3 mm thick and 27.6 mm high, and its depth changed with BMI.
- Injection: the toxin is placed inside the gland at several points. In a cadaver study, injections reached the submandibular gland accurately 50% of the time without ultrasound and 91.67% of the time with ultrasound guidance. For the parotid the figures were 79.17% and 95.83%, a difference that was not statistically significant.
The submandibular gland sits close to the neck muscles used for swallowing, so keeping the toxin inside the gland matters for reducing dry mouth and swallowing problems. The 2026 review regarded ultrasound as a basic safety measure for submandibular injections, though no clinical trial has yet compared results with and without it. Whichever clinic you choose, ask at the consultation how they confirm the position.
Planning Salivary Gland Botox on a Trip to Korea
- The consultation decides whether you need it. A gland that stands out is the reason to treat. If it does not, the treatment brings little change and can cause dry mouth. At Kondae PPEUM Clinic, Dr. Park explains what is causing your jawline first, and the decision is made with you.
- Do not judge the result before your flight. Studies measured gland volume at three and six months, and cosmetic data on when it starts is limited. The change is something you see over the following months, usually at home.
- Know the warning signs before you fly. In the Korean case report, severe swallowing difficulty began the day after the injection. If swallowing, speech or breathing becomes hard, get medical care right away wherever you are, and contact the clinic that treated you.
- Combined with jaw Botox? Ask which glands were treated and how much was used, so the combined amount and the interval can be checked next time, in Seoul or at home.
- Mention recent Botox at home. If you had Botox in another area recently, tell the clinic before treatment.
Kondae PPEUM Clinic is directly connected to Konkuk Univ. Station Exit 1 in Seoul. For booking, payment and what to bring on a first visit, see our first-time Korean clinic guide.
DR.BAQUO's Answers on Salivary Gland Botox
These are the answers Dr. Park Hwonham, Medical Director of Kondae PPEUM Clinic, gave in November 2026 to the questions people ask most often about salivary gland Botox.
How can I tell whether my jawline is from my salivary glands, or from muscle or fat?
"If the muscle that gets firmer when you clench your back teeth is what stands out, I think of Botox for the muscle. If the area below the earlobe bulges out even when your face is relaxed, I consider an enlarged salivary gland more likely. If the jawline as a whole just is not well defined, it can be body fat."
Is there anyone who is better off not getting salivary gland Botox?
"If the salivary glands do not stand out, there is no need for salivary gland Botox. It can even bring discomfort such as dry mouth, because the glands work less."
What should I do if my mouth feels dry or swallowing is uncomfortable afterwards?
"Because the other salivary glands make up for it, in actual practice it is very rare for people to go as far as having a dry mouth. If the symptom is severe, contact the clinic that treated you right away and get seen."
How often is salivary gland Botox repeated, and is it done together with jaw Botox?
"The metabolic cycle of Botox is generally known to be about six months, and to reduce the glands' function more actively, a maintenance interval of about three months is sometimes recommended."
What is different when I come from abroad for salivary gland Botox?
"So that it is a treatment done because it is needed, not blindly, I explain things carefully in the consultation and let the patient decide."
Salivary Gland Botox Price in Korea
Kondae PPEUM Clinic's standing prices for salivary gland Botox differ by product:
| Product | Price |
|---|---|
| Domestic Salivary Gland Botox | KRW 70,000 |
| Domestic Premium Salivary Gland Botox | KRW 99,000 |
| German Imported Salivary Gland Botox | KRW 150,000 |
| Imported US Salivary Gland Botox | KRW 250,000 |
Salivary gland Botox events in Korea
Kondae PPEUM Clinic regularly updates its events and packages, including first-visit prices and bundles with other treatments. The prices above are standing prices. For the latest Salivary gland Botox event prices and conditions, check the packages page.
See current events →Prices are subject to change. The total also depends on which glands are treated and whether jaw Botox is added in the same visit. For how Botox prices compare across areas in Korea, see our Botox in Korea price guide. When comparing clinics, line up the same conditions: which gland, which product, and how the injection position is confirmed.
FAQ — Salivary Gland Botox
Q: Salivary gland Botox vs masseter Botox: which one do I need?
A: It depends on what stands out. If the corner of the jaw gets firm when you clench, the masseter is the likely cause. If the area below the earlobe bulges even at rest and stays soft when you clench, or you can feel a separate lump under the jawbone, a gland is more likely. When both contribute, both are sometimes treated.
Q: What are the side effects of submandibular gland Botox?
A: The two to know are dry mouth and, rarely, difficulty swallowing. About two-thirds of resting saliva comes from the submandibular glands, so a dry feeling can follow these injections, though in practice a truly dry mouth is very rare. If swallowing, speech or breathing becomes hard, get medical care right away and contact the clinic that treated you.
Q: How many units are used for salivary gland Botox?
A: There is no fixed number for cosmetic use. A 2026 dosing review said the evidence for cosmetic doses in the salivary glands is still limited and that glands should be assessed separately from muscles. Doses from drooling studies were for a different purpose and are not a guide for a jawline. The amount is decided after checking which gland is enlarged and how large it is, and if you also have jaw Botox, the total for both areas matters.
Q: Are there salivary gland Botox before and after photos?
A: Not here. We do not have patient photos for this treatment, so this page is a guide. What has been measured comes from studies: parotid volume and thickness fell, and most of the reduction was still there at three months. The change develops over months, and results vary.
Q: Can I have salivary gland Botox and masseter Botox on the same day?
A: They are sometimes done together. Because the combined dose goes up, check with your doctor that both areas really contribute to the width, and confirm the amount and the interval for both.
Q: Will my saliva stop completely?
A: No. There are many salivary glands besides the parotid and submandibular glands, and the treatment reduces the secretion and volume of only some of them. Tell the clinic beforehand if your mouth is often dry.
Q: Does salivary gland Botox reduce fat under the chin?
A: No. Toxin reduces saliva-making tissue but not fat, and it cannot lift a gland that has sagged with age. If the fullness under your chin is fat, other approaches are considered.
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Sources
- Korea Ministry of Food and Drug Safety (MFDS), Drug Safety Nara. Nabota Inj. approval information — indications (benign masseter hypertrophy), precautions. nedrug.mfds.go.kr
- Korea MFDS, Drug Safety Nara. Botox Inj. approval information — indications, injection into or near anatomically vulnerable structures. nedrug.mfds.go.kr
- Korea MFDS, Drug Safety Nara. Xeomin Inj. approval information. nedrug.mfds.go.kr
- Korea MFDS, Drug Safety Nara. Botulax Inj. approval information. nedrug.mfds.go.kr
- Korea MFDS, Drug Safety Nara. Coretox Inj. approval information. nedrug.mfds.go.kr
Show 12 more sources
- Jost WH et al. Botulinum neurotoxin type A in the interdisciplinary treatment of sialorrhea in adults and children — update and practice recommendations. Front Neurol, 2023. PubMed 38162447
- Jost WH et al. SIAXI — Placebo-controlled, randomized, double-blind study of incobotulinumtoxinA for sialorrhea. Neurology, 2019. PubMed 30918101
- Yu YC et al. Efficacy and safety of botulinum toxin for treating sialorrhea — A systematic review and meta-analysis. Eur J Neurol, 2022. PubMed 34449931
- Jeong WS et al. The Volumetric Effect of Botulinum Toxin Type A Injection on the Parotid Gland — A Randomized Controlled Trial. Plast Reconstr Surg, 2024. PubMed 37010458
- Chen Z et al. Efficacy and Safety of Botulinum Toxin Type A in the Treatment of Benign Parotid Hypertrophy — A Prospective Study. Plast Reconstr Surg, 2022. PubMed 35994355
- Karapantzou C et al. Neurotoxin injection in benign submandibular gland hypertrophy — A first choice treatment. Laryngoscope Investig Otolaryngol, 2020. PubMed 32337352
- Jiang L et al. Localization of the Submandibular Glands Using High-Frequency Ultrasound. Aesthet Surg J, 2024. PubMed 38366013
- Lee MK et al. Radiologic measurement of submandibular gland ptosis. Facial Plast Surg, 2013. PubMed 23884853
- So JI et al. Accuracy of Ultrasound-Guided and Non-ultrasound-Guided Botulinum Toxin Injection Into Cadaver Salivary Glands. Ann Rehabil Med, 2017. PubMed 28289635
- Yang S, Yi YG. Dysphagia After Cosmetic Submandibular Gland Botulinum Neurotoxin Type A Injection — A Case Report. Healthcare (Basel), 2026. PubMed 41595371
- Chung WK, Kim MJ. Seven-Site Facial Contouring with Botulinum Toxin Alone — A Practical Framework. Toxins (Basel), 2026. PubMed 42931541
- Yi KH, Lee KL. Muscle- and Gland-Specific Dosing of Botulinum Toxin in Facial Aesthetics — Review of Dose Ranges, Target Depth, Muscle Thickness, and Neuromuscular or Glandular Anatomy. Toxins (Basel), 2026. PubMed 42931535
This is a general treatment guide, not a promise of any result. Results vary between individuals, and whether salivary gland Botox suits you can only be decided in a consultation. Doctor's answers: Dr. Park Hwonham, Medical Director, Kondae PPEUM Clinic, Seoul, from his review in November 2026.
DR.BAQUO | Hanlim Tower 2F, 229 Achasan-ro, Gwangjin-gu, Seoul | Konkuk University Station Exit 1 (Line 2) | Google Maps | LINE: @364kbfyj | global.drbaquo.com
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Kondae PPEUM Clinic
Dr. Park Hwonham (DR.BAQUO), Medical Director
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- Hanlim Tower 2F, 229 Achasan-ro, Gwangjin-gu, Seoul
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