Advice on Botox for masseter asymmetry? 2 wks post op and had different amounts injected on either side, is this normal? (photo)

Question

Due to TMJ, I noticed one day that my right jaw is more swollen than the left (pic attached) after taking my first selfie in years. Two weeks ago, I went and had 20 units applied to the right, 10 left. Looking for some advice: Would you agree applying more to the right is correct for achieving symmetry? I havent really noticed any difference (it feels diff, but appearance hasnt changed), and unsure whether I should get more. Should I wait longer for results? Thanks in advance!

Alexander Rivkin, MD · Answer

Hello and thank you for your question.  For most of my clients with TMJ, I inject different amounts on either side depending on a few factors (i.e. muscle size, strength, pain, etc).  I like to use the analogy of weight lifting.  Lifting weights and working out muscles of the body will build them over time.  Once you stop working out, it takes time for your muscles to shrink down again.  Same idea with treating masseters in TMJ; the Botox will reduce the ability (or potential) of the muscle, which will then shrink down in size as you are not "exercising" the muscle as much anymore. It is also important to continue your treatments every 3 to 4 months so that the muscle does not build up again.  Hope this helps. Best of luck!

Jason Emer, MD · Answer

Everyone has some facial asymmetries. Botox combined with radiofrequency can help slim the masseter and improve symmetry. Botox results resolve in 3-4 months. See an expert. Best, Dr. Emer

Sheryl D. Clark, MD, FAAD · Answer

Dear smorgasvein:The response to treatment of masseter hypertrophy is delayed, and typically requires multiple treatments, unlike the response to Botox in other areas. The muscles are relaxed by Botox within a week, no matter which muscles of the body are injected. But the masseter muscles will only get smaller as they are used less over time (just like the muscles of your arm, for example, when your arm is placed in a cast for a fracture. The longer the cast is on, the smaller your arm will get, because you are not able to contract the muscles.)  The best response will not be seen for 4 to 9 months.Every face is asymmetric. If you chew or grind your teeth more on one side than another, the size of the masseter muscles will be even more disparate. It sounds like you are on the right track, but you might ask if your parotid gland is enlarged on the right, just to be sure.All the best,   Dr. Clark

Alain Michon, MD · Answer

Thank you for your question. Botox is great at helping with  TMJ disorders and to slim down the lower face by reducing the size of bulging masseter muscles. Asymmetry of the face is completely normal. It is common that one masseter will need more Botox. It may take a few weeks before seeing any results. Follow-up injections is usually 4 to 6 weeks after the initial visit. I hope this help. All the best, Dr. Michon

Leonard Grossman, MD · Answer

No matter how much Botox is injected, you will not achieve symmetry. Your face is asymmetric as it is in every single individual on this planet and this amount of asymmetry is secondary to the skeletal build. I would continue to use botox for treating your TMJ. Good luck from New York City

Advice on Botox for masseter asymmetry? 2 wks post op and had different amounts injected on either side, is this normal? (photo)

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Answer: Botox for masseter hypertrophy and TMJ disorder

Answer: Botox for masseter hypertrophy and TMJ disorder

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Advice on Botox for masseter asymmetry? 2 wks post op and had different amounts injected on either side, is this normal? (photo)

Answers (8)

Answer: Botox for masseter hypertrophy and TMJ disorder

Answer: Botox for masseter hypertrophy and TMJ disorder

Answer: Botox question

Answer: Botox question

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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.