Botox in Masseters Resulting in Buccal Fat Pad Herniation - New York, NY

Pros: Last time I had this treatment done, I loved...

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 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.

hi im thinking of having this done for TMJ jaw pain,, 40cc seems a bit much? thought avg was only 25.

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!



I think it may be getting slightly better. No one...

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.

I doubt anyone is reading this, but, just in case,...

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.
how are you doing now doll?
Hi I experienced the same side effect as you- except that they were on both cheeks. Doctors I spoke to never heard of this side effect. I'm seriously considering buccal fat removal.
Hi I expEriencec

I'm doing very well thank you! My masseters are...

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!
Hi KitteNYC, I've had a similar thing happen to me. Botox in the masseters (for teeth grinding and square jaw shape) - three treatments in less than 5 months. I now have jowls and my masseter has wasted away, my face shape is unnaturally thin and oval (I've always had a heart-shape face) and I look so different to my former self. I am absolutely miserable. I was wondering how you're going now, and if you managed to build up the masseter muscle again to get your face shape back? Did your buccal fat pad return to it's original position? I hope you're doing well and have recovered 100% from this experience - it's amazing how much of a toll it takes on your quality of life. Thank you :)
KitteNYC, I am so very glad you shared your experiences. Thank you. I've also read your other posts on this subject. I, too, have been experiencing "chipmunk cheeks" for the better part of a year or so, but I had NO IDEA it was the Botox!! No doctor could tell me what the problem was & why my face had changed so. It was severely upsetting, and it was only when I spoke with a spiritual healer who has known me for the last 20 years that the truth came to light. Even she said that when she last saw me she had to do a double-take because she couldn't believe it was me! The worse part is that all the while, I kept using Botox because I didn't know what it was doing to my face. Most doctors have said that the effects of Botox last 3-6 months, but it's been over a year. While I feel better knowing WHAT has caused this change in my face, I'm also scared that it could be permanent. I am swearing off Botox forever! And God bless Dr. Kenneth D. Steinsapir, for if it hadn't been for his answer to your post 'Unilateral Facial Swelling After 40 Units of Botox in Masseters, Is This Reversable?', I would have never researched the subject further. Good luck on your transition, and be well! Thanks again.

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. :)

Name not provided

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.

2 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
1 out of 5 stars Answered my questions
3 out of 5 stars After care follow-up
4 out of 5 stars Time spent with me
4 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
3 out of 5 stars Wait times
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