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

and now one side of my face is contracted tighter than the other side. Does that mean that the Dr. injected more to one side?

Doctor Answers 9


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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. 

Bay Area Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Asymmetry of jaws after Botox

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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.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Botox for Masseter (Jaw) Muscle

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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.

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

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Botox to masseter muscle to reduce jaw prominence

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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!

In Beverly Hills and Los Angeles

Sarmela Sunder, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Tight Face After Botox for Jaw Slimming

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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.

Karen Vaniver, MD
Kennewick Plastic Surgeon
5.0 out of 5 stars 38 reviews

Botox to Jaw maybtake adjustment doses

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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.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Botox for jaw slimming

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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.

Bryan K. Chen, MD
San Diego Dermatologist

Botox for Jaw Slimming

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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

Larry Fan, MD
San Francisco Plastic Surgeon

Sure this is possible.

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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.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 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.