Botox for Masseter Hypertrophy/Jawline Slimming/Bruxism?

I had 30 units of botox injected into each of my masseters. According to my research, this procedure is usually done in three injections. However, my doctor only did one injection on each side and moved the needle around the masseter once it was inside. Is this common practice? Secondly, after the injections, the doctor said to not massage the injected areas. However, according to my research, it is recommended to massage the areas. Is this normal or should I change doctors?

Doctor Answers 8

Botox technique for masseter reduction

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The injector used a single needle stick to minimize needlesticks (presumably). This is a technique that is possble as the injector was trying to use less needle sticks and instead was moving the needle tip while inside with a single dermal inection site. This, according to some injectors, reduced bruising.

Botox for Masseter Muscle

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Hi Scarred.  When we inject Botox (or Dysport) into the masseter muscle, we typically use 25 Units (75 for Dysport).  The injections are usually performed 3-4 times per year.  

The product is not massaged once injected and a good injector will not need you to move it around once it is placed.  Good luck.

Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

Botox for masseter muscle

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When injecting Botox for the masseter muscle, or any other treated muscle, it is important to distribute the Botox throughout the muscle.  This can be done with multiple injections or it can be done with fewer injections that are spread under the skin.  The result should be the same but the techniques are different. In regards to massage, this will vary from doctor to doctor as well.  Some may recommend it and others will not.  As long as the Botox is injected throughout the muscle, I don't think massage or no massage will make much of a difference.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Botox and Dysport for jaw slimming

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Thank you for your question. Botox or Dysport can be a very effective way to contour the jaw line by reducing the masseter shadow through the outer jaw skin. In addition, it can reduce symptoms of jaw clenching or grinding of teeth at night time. This is an advanced technique that requires a strong understanding of the underlying anatomy. Some side effects can results in some very unintented effects. This can include affecting the smile due to diffusion of the Botox into neighboring smile muscles. Over treatment can also overweaken your jaw muscles making it harder to chew food and causes your jaw muscles to relax too much when you sleep.
The injection technique does vary by physical exam and the goals of the treatment. Facial contouring goals may change the injection sites themselves to affect different portions of the masseter as well as the dose. The strength of the masseters can be felt by palpation and also helps me to determine dosing. In general, I start with 15- 25 units of Botox (OR 50-75 units of Dysport) per side for most patients.  I do not massage and usually distribute the Botox/Dysport between 4-5 injections on each side. If they have very strong masseters, then I may increase the dose, but more commonly ask them to return in three weeks for a touch up. Once you get the desired result, I let patients know that future treatments may require less to maintain the look or the jaw clenching symptoms, especially if they get treated as soon as they notice the symptoms return. This can be as soon as three to four months, but in some cases, patients report that it lasts six months or more. I find it depends on the dose we use and how many times we have done the procedure as the duration may lengthen for patients that repeat it regularly.

Masseter Injection Technique

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   The technique utilized is reasonable and, if performed correctly, achieves the same results as another technique.

Botox and masseter treatments

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Depending on the injector, techniques vary. Discuss your expectations and get educated on what your provider does and why to feel better about your treatments going forward.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Botox for masseter hypertrophy

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From your description, your doctor treated you appropriately and gave you good advice - do not massage any area that has been treated with Botox.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Botox to masseter muscle

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I usually use 30-50 units split between the two sides and perform multiple injections.  It will take several months and treatments to see results,.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.