Jaw Shifting to the Right After Botox for Square Jaw Reduction?

Hi its been 5 months since Ive had botox. I had and still have a lot of numbness at the bridge of my nose, cheeks and gums near my right wisdom tooth. Its lessened now tho. However, now my jaw is moving to the right now about 5cm from the centre. I then have to conciously bring it back to the centre. This has occured only since the past one week and its getting worse. What could i possibly do to avert this besides using the living nightmare of botox again? A dentist thinks its loss of muscletone

Doctor Answers 3

Botox to reduce a square jaw

Botox is only FDA approved for use near the glabella (the area between the eyes) to reduce wrinkles, but "off label" injection into other muscle groups is becoming more popular. Use in the masseter (chewing) muscle can decrease the bulk of the muscle by keeping it relaxed, and that can narrow the jaw slightly. 

The effect is temporary (usually 3-5 months), so having any abnormality in jaw movement or sensation after that time is either a sign of nerve damage from injection right into the nerve or because the symptoms are due to something else. 

Any problems with pain or deviation when the jaw opens and closes should be evaluated by a dentist or oral surgeon.

Jupiter Plastic Surgeon
5.0 out of 5 stars 34 reviews

Botox treatment for cheek muscles

Treatment with Botox to reduce muscle bulkiness of the cheeks should be done by a trained expert who is board-certified. If the masseter muscles are treated there shouldn't be asymmetry in the position of the jaw's position as these muscles are active in those who clench but it may happen with the pterygoid muscle which can be overstimulated by those who grind their teeth side to side. Numbness should not occur as botox interferes with the transmission of neural signals in muscle receptors, not sensory nerve receptors. Possibly a nerve was irritated by the injection. 

See an expert such as an ENT facial plastic surgeon who treats TMJ (temporo-mandibular joint syndrome) with Botox.

The information provided in Dr. Shelton's answer is for educational purposes only and is not intended to constitute medical advice.  The information provided should not be relied upon as a substitute for consultations with a qualified health professional who may be familiar with your individual medical needs.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 37 reviews

Problem with occlusion

Your experience with masseter reduction with Botox is certainly not a typical one. My patients are always pleasantly surprised how painless and quick the treatment is.  Numbness at the bridge of your nose, cheeks and gums is certainly not typical for this procedure.  When done well, the procedure is extremely safe and effective.

That being said, 5 months after the injection your muscle activity has returned and should not affecting your occlusion in the way you are describing.  I'd recommend seeking a second opinion from a qualified dentist/oral surgeon.  


Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 57 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.