Botox Masseter Reduction for Masseter Hypertrophy and Bruxism (Teeth Grinding)

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28 year old Asian woman with Masseter Hypertrophy and Bruxism (Teeth Grinding) treated with Botox to her masseter muscles. Her right masseter was noticeably larger than her left side. This assymetry in her masseter muscles was due to her preferential chewing of food on her right side. Her right masseter was injected with 40 units of Botox and her left side received 36 units of Botox. The effects of the Botox begins within 3-5 days after the Botox injection. The time it takes for the muscle bulk to shrink is about 2 weeks. During this time, the main feeling for the patients weaker chewing, and some times fatigue when chewing for longer periods of time or chewing crunchy or tougher foods. Her after photo was 4 months after the initial Botox injection. She could have waited longer, but due to travel, she opted for a smaller dose of Botox to maintain the already cosmetically pleasing result. In her after photo, since she already liked the cosmetic result and the improvement in symmetry, she received 20 units of Botox on both sides (as opposed to the assymetric dosage on her initial treatment), to maintain the result, but not necessarily shrink the jaw width any further. Note that even though she is returning for a touch up treatment, her cosmetic result is still maintained. Her main reason for returning to receive more Botox injections is when she feels tension in her jaw or notices that she is grinding her teeth more. Before she fully bulks up her masseter again she can be retreated with a smaller dose of botox to maintain the muscle relaxation as well as the cosmetic result. She can wait longer and allow her muscle to bulk up more, and this longer interval would mainly result in more Botox being used at the touch up session. Additional tips given to the patient to help lengthen the duration between Botox treatments, are strict avoidance of hard, chewy or crunch foods, no gum chewing, chewing on both sides of her teeth as equally as possible. The less "work out" the masseter muscles receive, the less they will hypertrophy.

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