Recently Had Botox for Jaw Slimming - One Side of Face is Now Tighter

By "tighter" do you mean that your facial expressions are restricted on one side more than the other? Most patients don't experience tightness when treated for jaw slimming.

 

If the Botox has been injected too high then there is a chance of having a tight feeling when you try to smile/move. 

One of your chewing (masseter) muscles might have been larger than the other before treatment with Botox and compensation now can be done to equalize the muscle mass.  There is a possibility that one side is compensating by trying to clench harder since the other has started to show its relaxation.  Depending on when the Botox was injected, you may feel a relaxation on the side that bothers you in a few days. If however it has been more than three weeks since your Botox, you should see your doctor to have an evaluation and possibly more Botox.

Hi IE.  It's difficult to say exactly what's going on without asssessing you, but there are a couple possibilities.  One is that the "tightness" is just the ability to more effectively clench the jaw on that side.  This may mean that not enough Botox was injected or that this side may need additional units to relax the muscles to the same extent as on the other side.

The other issue is that we often hear patients describe a "tightness" or heaviness  in the forehead area after Botox is injected.  We hear this from new patients quite frequently.  Perhaps you are having this same feeling with your jaw although it would seem unusual to have the tightness on only one side. 

A quick call or visit with your practitioner may help you answer your question.

Hi,

In order to achieve the appearance of a slimmer jaw, your injector most likely injected your masseter muscles which sit along the sides of your jaw and face. With repeated use and contraction, the masseter can become thick  and prominent. By placing Botox into the masseter muscle, we are able to make this muscle relax and as a result, create a softer appearance at the sides of the jaw.

While it is possible that your injector placed more Botox on one side than the other, it is just as likely that your masseter on one side required more Botox than the other side. All of our faces are asymmetric, and this applies to the muscles in our faces, as well. So it is likely that your masseter on one side was stronger than the other to being with. In fact, generally, the masseter on the side where you preferentially chew is actually the stronger masseter. The stronger masseter just requires a bit more Botox than the other side to achieve the same result. Discuss your concerns with your injector and he/she should be able to evaluate and treat you appropriately.  Hope this helps. Good luck!

Dr.Sunder
In Beverly Hills and Los Angeles
 

However, it is also just as likely that the exact same amount was used but that it diffused and was taken up a bit differently on the two side to account for the differences.  Please see your doctor and let them assess what is going on.

Hi iu2247, thank you for your question! Injecting the masseter muscles typically requires a higher dose of botox (60 units) due to the thickness and mass of the muscle. It is common to naturally have one masseter stronger/larger than the other, in these cases it may require a higher dose of to be injected into that muscle. I recommend following up with your injector. 
I've created a video that reviews treating the masseter muscles with Botox. I hope this information is helpful in your research! 

Most people are asymmetric to begin, and the bulk of the masseter muscle is no exception.  I would encourage you to follow up with your practitioner to evaluate you in person.  Perhaps some pre-treatment photos were taken for comparison purposes.  If an even amount of Botox was injected to both sides, maybe you are seeing an accentuation of the asymmetry that was there to start with.

Dear iu2247,

It's possible that your doctor injected more Botox on one side than the other. It's also possible, however, that the Botox is having a different onset of effect or different total effect on one side versus the other, and/or that your jaw muscles were uneven to start. I would return to your doctor. You may need a little bit more Botox on one side.

Warmest wishes,

Larry Fan, MD

The masseters are the muscles that our jaw uses to chew. In some races or individuals, jaw clenchers, or teeth grinders, the masseters hypertrophy, becoming thick and heavy. By weakening the muscle with Botox, its size reduces from relaxation. It is rare that these muscles would be completely symmetric to begin with. Differences in relaxation or tightness may result from initial differences in the muscle, differences on the rate of onset and maximal effect, differences in dose, and effect on other facial muscles. Your surgeon can help adjust this by injecting a bit more in the tighter side. Massage may help, and this sensation will ease up with time.

Botox can reduce the size of facial muscles, like the large Masseter muscle of the jaw, but the actual size of one muscle may be different than the muscle on the opposite side. I would have follow up injections of Botox to each Masseter at 4-6 months intervals adjusting the dose as needed to each side. Most likely it will take 3-4 treatments to get the muscles permanently reduced.