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“Botox in Masseters Resulting in Buccal Fat Pad Herniation - New York, NY”
Spent: $640 in NYC
Pros: Last time I had this treatment done, I loved the result. I loved my more contoured, feminine jawline, and the atrophy of my masseters has really brought out my cheekbones.
Cons: This time, I had the same amount injected, but it seemed to have caused an over-weakening of my left masseter, resulting in "pseudo-herniation on the buccal fat pad." When I smile, a distinct lump is visible next to the left corner of my mouth. It messes up my facial balance and causes asymmetry. The left side of my face looks like it did when I was 15 years old: chipmunk cheek.
I had 40 units injected in each side. Why this only happened to one side, I don't know. I'm praying this goes away once the botox wears off...in the mean time I'm chewing lots of gum to rebuild the muscle. If this doesn't resolve by itself, I'll need to either have the fat pad pulled out (buccal lipectomy) or have it resutured into its previous position (this is a much better choice for me, as I'm only 18 and having a one-sided buccal lipectomy at this age would surely result in extreme facial asymmetry later in life). If any of you have had a similar experience from treating your masseters, or if you know a very skilled doctor who may be able to shed some more light on this very specialised subject, PLEASE share your thoughts. I'd love feedback as this condition is causing me extreme anxiety and depression.
Updated on 5 Sep 2011:
I think it may be getting slightly better. No one has ever heard of this side effect before. I believe I'm the only one to have ever experienced this.
Updated on 20 Oct 2011:
I doubt anyone is reading this, but, just in case, I'm positive it's better than it was in these pictures. By quite a lot. I'm absolutely not able to demonstrate the asymmetry to this degree anymore. I feel comfortable smiling despite a slight imbalance and "tight" feeling in the affected cheek. I will update in two months.
Updated on 17 Apr 2012:
I'm doing very well thank you! My masseters are back to around 80% their original size and it looks MUCH better than that sickly narrow face I had before. That dr put SO MUCH BOTOX into my face it is astounding. This was a year ago and yes, there is still very, very slight asymmetry, but it's not even bothersome anymore. I also started my transition (male to female) so the estrogen is rounding out my cheeks and making my face look much softer so whatever asymmetry remains will blend in now. I'm also on Prozac so I feel much better all-around! I am SO GLAD I didn't do anything stupid like a Buccal fat removal or resuturing the fat pad...Jesus that would be a disaster!
This review is the subjective opinion of a RealSelf member and not of RealSelf, Inc.
Helpful review?
My Doctor: name not provided
My rating:
Go to someone who specialises in the injection of botox to the masseter muscle. This is apparently a very important facial muscle and while anyone can push down on a syringe, very few know the possible consequences.

Hi Robin,
That's crazy! I wonder why it happened. You might want to check out the answers to the question, "How Can I Get Rid of Botox Side Effects?" It might help, hopefully it will leave your system soon. Please keep us updated.
Thanks so much for the review, and have a great weekend!
-Britt
KitteNYC it made me a bit sad when I read your comment that you doubted anyone was reading this. I want to thank you for sharing your story & experience with us all and make sure you know that tons of people come on & read the reviews everyday. Some people prefer to stay more anonymous and don't comment, but don't doubt for a second that what you have shared has helped many others in making their decision of whether or not to try Botox.
I'm so glad to hear you are seeing improvement & I look forward to hearing more updates from you!
They were from spammers - we do all we can to prevent them but sometimes they still get through, ugh! Sorry about that guys. I have blocked their accounts & erased the comments.
Great to hear such a positive update from you kitteNYC! We recently launched a Gender Reassignment community. Despite the name it is open to all going through transition so please feel free to join in the discussions there as well. :)