Protrusion after getting masseter Botox? Is this normal? (photos)

Botox takes a few weeks to work, I would give it time to show its true results. If you are concerned please speak to your physician. Best, Dr. Emer.

One day after Botox you would not see much if any change. There may be some swelling due to the injection, but it would take 7-10 days to start noticing any changes.

Your bulge will be improved with a small dose of botox. I usually do it whenever it bothers a patient. This occurs occasionally but is easily remedied.

You don't mention how long ago your injections were done. Sometimes there can be some swelling from the injection process which may give the appearance of a protrusion after the treatment. Another possiblity is that 15 units is a very conservative dose for the masseter muscle. It is quite possible that you still have muscle function left and additional Botox may be required. Botox in the masseter muscle can take up to 2 weeks to fully take effect. If after 2 weeks things are still the same then you should follow up with your injector for more treatment if needed. Best of luck to you.

Botox will typically take a week for full effect.  As the Botox relaxes the muscle the bulge should be addressed and flattened.  If there is still significant muscle movement after treatment, additional Botox is necessary to achieve full effect.  

Thank you for your question and for sharing your photographs loudestsilence951. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam in the office where I can view the skin in multiple angles and observe wrinkles formed with facial expression. However, I hope the information provided here is useful.Botox can be placed in the masseter muscle in the lower face to contour the lower face and address pain associated with TMJ. In this area 20-40 units of Botox are used per side. Depending on the reason for the enlargement of the muscle, permanent results may be achieved. For example, some people have a habit of grinding, clenching, or biting their teeth subconsciously. Often times this happens in their sleep when they are not aware of it. Botox placed in this muscle will relax the muscle and the grinding, clenching, and/or biting will decrease. This will reduce the size of the muscle. If the brain gets accustomed to this and the person stops grinding, clenching, or biting, then the muscle will not become enlarged or as enlarged again. However, if the habit starts again, the muscle will likely get larger.

To determine if someone is a good candidate for this treatment it is necessary to look at a person’s lower face when biting and comparing it to when the person is not biting. If a bulge is seen on the outer portion of the jawline, then the person is likely a candidate. It can also be felt with the fingers when biting.The pivotal studies demonstrated that the peak results are seen 14 days after the treatment and most people enjoy their results for 3-4 months. At that point, a maintenance treatment is recommended. While some people start to see results as early as the next day, it can take two weeks for full results so patience is important. We have our patients return two weeks after their treatment to assess their results via photographs. At that time additional units may be added if necessary.If I had a patient with the concern described here I would recommend waiting a full two weeks prior to assessing the results. Sometimes there is swelling from an injection and sometimes a deep bruise can lead to the appearance of a bulge. But generally the muscle is not relaxed after a single day so changes described are possible.With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.

After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

Hi loudestsilence951. I'm sorry to
read that you're bothered by the results of your recent BOTOX treatment.
Because you got the injections only a day ago, it's possible that this
"bulge" is actually just swelling, a common and temporary side effect
of BOTOX injections. If you notice it persist for more than a week, contact the
physician who performed your injection for a possible revision. Best of luck to
you.

1. First of all it is still too soon to determine the real effects of your masseter injections given that it typically takes 2 weeks to notice visible results.2. As you pointed out the dose that was used in your case is relatively low, so the likelihood of getting any significant complications with such a low dose are minimal. I would not worry at this stage and try to be patients! Good luck. 

You received an extremely small amount of Botox and not nearly enough to taper the masseter. Not sure where it was injected but seems that it weakened an area above and below where the protrusion is \which will disappear within  aweek or so. if you want tapering of the masseter it will take much more and be sure you see a board certified dermatologist or plastic surgeon

After any injections it is really important to wait a week for things to settle down.  I wouldn't rush to have more injections done just yet.  There may be some mild temporary swelling, from the injection itself, which is appearing as a bulge.  Be well.