Do I have hypertrophied masseter muscles? Advice?

Question

Hi, The last few months I have woken up to a very tightly clenched jaw, I do it in my sleep. I saw a dentist and they also told me I am probably grinding my teeth at night too because my teeth have become very sensitive and are starting to wear. I have been wondering also if my jaw looks more square-ish recently... I am getting older and have gained some weight since but it definitely looks wider than when I was a teenager (for reference, I am 21 now). I'd appreciate any advice, thank you.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  it does appear that you have masseter hypertrophy, that along with your symptoms, should see improvement with careful Botox placement.

Jason Emer, MD · Answer

you have larger muscles but that is normal in some people. botox can be used to slim the face.

most of my younger clients use fillers to give them shaping especially on the cheeks, jawline, and chin which make the face look more slim and tight; and threads such as PDO or Instalift can build collagen and support the facial shaping and skin looseness over time, slowing down the aging process and given the face a more “snatched” look; and morpheus deep microneedling RF can tighten crepe skin especially on the neck and jawline and is great for long term tightening of the full face, neck and chest; its often used to give the face a slimmer more sculpted look because it tightens the skin and gives lift.  an early face lift can be performed as well even in younger clients if they want a different facial shape, maxillofacial surgery with bone breaking or shaving can also be done.

For facial slimming a combination of treatments are always needed.  Options include:
1. Buccal fat pad removal to reduce fat on the lower face
2. Factite or Renuvion/J Plasma to tighten the lower face, jawline, and chin to reduce fat and give the jawline and neck tightening and shaping.
3. Botox to the masseter to reduce the muscular size of the jaw giving the face an illusion of being more slender
4. Fillers to the jawline, chin, cheeks, temples and brow help to shape the face and make it more angled and defined

Always use at home derma rolling (see link to Emerageskin x anteageMD roller plus stem cells/hyaluronic acid ampules) and peels like emeragecosmetics enlighten or aerify that can be used to improve skin quality and tighten the skin while improving wrinkles, pigmentation, acne, and Melasma.

See an expert who does facial shaping with surgical and non surgical methods to get a comprehensive option.  Best, Dr. Emer.

Harold J. Kaplan, MD · Answer

Hello Claire.  It does appear that you have some masseter (muscle) projection at the jawline below the ears.  Not only can Botox (Dysport) help with slimming this area, but it will also help with any pain or headaches associated with the teeth grinding.  Finally, it can help preserve your teeth if you are grinding at night.  We use 75 units of Dysport each side and this is comparable to 25 units of Botox.  Results usually last for 4-6 months.  Best of luck.

Kevin Tehrani, MD, FACS · Answer

Hi, thank you for your question and posting an appropriate picture. You seem like a good candidate for masseter Botox. Most patients will have TMJ relief as well as better facial contour with good harmony with injections about twice a year.  Best to see an expert inject her with experience in this area.

Onir Spiegel, DDS, PhD · Answer

If you are waking up with a tightly clenched jaw, you are also likely grinding your teeth at night. This is very common and it is easily treatable with Botulinum injections to the masseter muscle. Botulinum (aka Botox, Xeomin, Dysport, and Jeuveau) acts as a neuromodulator to break up the acetylcholine that neurons secrete during muscle contraction. Hence, botulinum acts as a muscle relaxant and will improve your jaw clenching. All the best from Boston, Dr. Onir

Sheryl D. Clark, MD, FAAD · Answer

Hello Claire daisy:

You can achieve a very natural-looking and impressive result by having botulinum toxin A (Jeuveau, Botox, Xeomin, Dysport) injected in the masseter muscles.   Some women naturally have a more square face and strong muscles along the jawline, and people who grind their teeth can have large or hypertrophied muscles along the jawline, often along with pain and damage to teeth. By injecting the equivalent of 15 to 30 units of BTX-A to each side, a dramatic result can be seen.   I have been able to help patients who have been grinding their teeth for decades and have failed all other therapies including night guards, and some patients love the subtle slimming effect this has on their somewhat round or square, or even triangular-shaped faces.

The key is to be subtle enough in the treatment to preserve facial characteristics that make you who you are, to understand ethnic features, how cultures vary in what they define as beautiful,  and to avoid anything that would look unnatural. You still want to look like yourself, and I believe in your case treatment will restore the way you used to look and help you to break your habit of teeth-grinding.

Sheryl Clark MD, FAAD

Do I have hypertrophied masseter muscles? Advice?

Answers (6)

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