Botox Injection Possible on 1 Side of Jaw?

I have a prominent jawline on one side of my face and had Botox on both jaws before. On the side with the larger jaw, I noticed that its masseter muscle is "more active." Now I'm planning to ask my dermatologist to inject 5-10 units of Botox on just one side of my face to see if it will cure the lopsided problem. Is it possible? Is there any risk for injecting Botox on one side of the jaw?

Doctor Answers 11

Botox for one side of jaw

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It is possible to inject only one side of your jaw with Botox to achieve better symmetry. The risks remain the same for the treated area.

Botox for the masseter muscles

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Botox can be used to relax the masseter muscles.  If one side is stronger than the other, more Botox can be injected into the stronger side without any problem.

Martie Gidon, MD, FRCPC
Toronto Dermatologist

Asymmetric botox injection can bring desired results

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Botox can be injected into only one side without any problems.  The botox will work only where it is inejcted.

I will inject botox in an asymmetric fashion if a patient as an asymmetric face.  In this way, Botox can be used to make asymmetries more subtle.  

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It is possible to have Botox injected in only 1 side

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Asymmetries may be balanced by injecting one side only. Some patients who have had medical conditions creating significant differences from side to side can be balanced by treating only one side. Your more active side might be “waking” up quicker than the other side and you may need to get the other side treated soon, also. What you don’t want to have happen is for one side to work and the other not. Such an imbalance might create a malocclusion of the teeth or an improper bite which might cause TMJ (temporomandibular joint) pain which can be quite painful and annoying in the jaw.

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

Botox in the masseter is effective

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Botox injections in the masseter can be very effective. However 5 to 10 units is way to low. You will need somewhere between 40 and 60 to make any difference. Please discuss this with your dermatologist and make sure he/she has experience with unconventional Botox injections. Good luck.

Botox can help with masseter muscles hypertrophy

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Even though injecting Botox into the masseters is an off label use of Botox, this treatment is very helpful in improving hypertrophy of the masseters.

Some patients do have one masseter larger than the other side and the amount of Botox can be different on each side depending on the hypertrophy.

The improvement however is teporary and the treatment will have to be repeated every 3-4 months.

Nissan Pilest, MD
Irvine Dermatologic Surgeon
4.6 out of 5 stars 23 reviews

Botox for asymmetrical masseteric (jaw) hypertrophy

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This is one suggested temporary treatment of masseteric hypertrophy. There are many potential risks for asymmetric injection including occlusal disturbances and possible TMJ complaints. However, the risk of this appears to be relatively low from reported studies.

Remember that if the problem is due to a bony condition, Botox will have no effect. Also the Botox must be repeated on a regular basis to maintain the result.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Asymmetric treatment is common.

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Dear Prettyprints

Facial asymmetry is common and altering the dose of BOTOX to account for muscle mass asymmetry is often done to account for such differences. The doses you are referring to sound about right.

It is best to undertreat these issues and have more placed 4 to 6 weeks later. Once it is clear what dose you need, at the next treatment the full dose can be given.

Dr. Steinsapir

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

Botox helpful for masseter muscle hypertrophy

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I perform Botox injections to the masseter muscle to help reduce fullness in this region. If you notice that one muscle is larger than the other, it is reasonable to discuss more medication on this side with your dermatologist. Keep in mind that there is a safe limit to how much should be injected within a 3-4 month period, and your physician will not want to go over that amount. I would also wait until all of the previous medication has worn off prior to proceeding. To our knowledge, there is no risk of injecting in this region, although it is considered an "off-label" use by the FDA because they have not reviewed Botox for this indication. Good luck!

Botox on the masseter muscle

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There are some doctors who treat masseter hypertrophy with Botox injections.  Adding more to one side that appears to be bigger sounds reasonable. But remember, that one side may appear larger because of the underlying bony framework and not so much because of the muscle.

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.