How Can I Tell if I Need Botox in my Masseter Muscle?

Muscle hypertrophy vs. jawbone enlargement is different in shape.  The jawbone enlargement, often is from front to back not side to side, but if you are still wondering if it is the bone structure, then check the position of the widening.  lower cheek widening is jawbone, and masseter muscle enlargment or hypertrophy is mid cheek.  in the olden days, mid cheek buccal fat pads were removed by plastic surgeons to help create a better defined cheekbone but this can lead to an appearance of premature aging as thin cheeks indicate illness, tiredness, and fatigue.

If you feel a bulky mass when you clench, that is your masseter!  Botox can slim down that bulk.  

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. 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.