Swelling in lower face 6 weeks after masseter Botox injection? (Chipmunk cheeks, lost jaw definition) (Photo)

Question

I received intra-masseter Botox injections 6 weeks ago for TMJ. Initially, the swelling around my masseter/lower face vanished, but I recently noticed new swelling around my jaw. It appears to be in the region of the buccinator, styohyoid, and gastric muscles. I'm a little worried because my jawline here has lost definition, in addition to the appearance of chipmunk cheeks. Is this due to the Botox? What could I do to stop the swelling? Thank you in advance!

Gregory Mesna, MD, FACS · Answer

The Botox is very effective at decreasing the activity in the muscle and weakening the effect of the muscle on your TMJ. As the muscle is weakened (to decrease the effects on your TMJ's) you will naturally lose some of the tone and definition of the muscle which may be visible in the lower cheek areas, along the jawline. I would think that it would be unusual for you to see swelling at this point but you may be seeing some laxity and sagging of the muscle mass. Have you noticed if your TMJ symptoms have improved? If they have, and you like the effect that it has had on your symptoms, then when the Botox wears off you might try a smaller amount of Botox the next time. I think Botox is an interesting treatment because if you get a result that you do not like, you can wait for it to wear off and then try something different. On the other hand, if you get a result that you do like, that will also wear off and it will have to be repeated. Be patient and establish a list of pro's and con's from the treatment to help you decide if it is something that you will want to repeat in the future.

Brian Arslanian, MD · Answer

Hi thereSorry to hear about your problem you are experiencing.  Honestly, based on the photos, what are you talking about is pretty subtle.  The relaxation of the masseter muscle can lead to some initial sagging of the skin and repositioning of fat in the face.  This will usually settle out, but sometimes may not.  If you really don't like it, then either don't repeat the Botox, try a smaller dose, or see another provider.  Unfortunately, it may be a situation where you might have to take one trade off for another.  Good Luck

Swelling in lower face 6 weeks after masseter Botox injection? (Chipmunk cheeks, lost jaw definition) (Photo)

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