5 months post masseter Botox - will my asymmetry even out with more time? (photos)

Question

Hello. In April ‘22, I started to hav TMJD symptoms on only one side of my jaw (left). In Oct ‘22, I received 30 units of Botox per masseter and 5 units in each temporalis muscle. The left side masseter did not seem to take to the Botox (still had very bad muscle soreness, I presume from clenching at night). I know asymmetry is common, but now, 5 months post injections, my left side looks very disproportionate to the right side. I’ve also lost cheek fullness. Will this even out with more time?

Eric M. Joseph, MD · Answer

I can see your concern of slight asymmetry, but this is not likely seen by others. In all likelihood, your Botox is nearly completely worn off. Did you lose some weight? If this is bothering you, please consider bringing this to the attention of your physician. Hope this helps! Dr Joseph

Jason Emer, MD · Answer

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan.  It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

James M. Economides, MD, FACS · Answer

Given that your symptoms did not improve as much on the left side, I would likely advise either reapplication of the Botox to ensure proper placement or increasing the dose on that side. It is likely that your left masseter is more active than the right and may need a higher dose to achieve similar effect as the right. With time and proper dosing and placement, the asymmetry can even out.

Camille Cash, MD · Answer

Botox effects are temporary, typically lasting three to four months.  If you still have not noticed improvement by six months the differences are likely no longer a result of Botox.  Although we are all asymmetrical to some degree this asymmetry can be impacted by a number of factors.  Some include weight loss/gain, side you sleep on, and normal aging.  You also mentioned that you clench which could impact the muscle.

Kimberly Mascia, MD · Answer

Hi there, 
Unfortunately, I’ve seen this just once in a very thin client whose Botox appeared to have migrated into the smile muscle above the masseter. Injecting the depressor angular oris muscle on the left could offset this slightly. Your cheek muscle atrophy could have occurred by migration of Botox to those muscles as well. Try exercising the affected muscles. Please let us know how you are now.

5 months post masseter Botox - will my asymmetry even out with more time? (photos)

Answers (7)

Answer: Botox longevity

Answer: Botox longevity

Answer: Risorius injected

Answer: Risorius injected

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5 months post masseter Botox - will my asymmetry even out with more time? (photos)

Answers (7)

Answer: Botox longevity

Answer: Botox longevity

Answer: Risorius injected

Answer: Risorius injected

Browse related questions

Recommended reading

Everything you need to know about Botox

Our mission is to create a world where every investment in modern beauty is Worth It.