Botox for TMJ and face hollowness. Advice?

Question

I got botox for my TMJ twice. I loved the results at first, when they started wearing off, I got it again. I feel like my cheeks are looking more hollow and so are the sides of my forehead, there the muscles flex when you chew. Since the muscle was weakened, can this be a result of the botox? My headaches have come back, for now I am just taking ibuprofen. I don't want to get it again if it is going to make my face look like a literal skull with no flesh.

Michael A. Zadeh, MD, FACS · Answer

It's impossible to tell what the cause of your face hollowness is without an in-person consultation, examination, and comparison of your before and after pictures. Volume loss in the cheeks and the temples respond well to treatment with Sculptra and Fillers.

Jason Emer, MD · Answer

Botox will only effect the muscles treated. However, volume loss can occur due to aging, genetics, weight loss, etc. Volume of the face can be created with well-placed fillers (Voluma, Radiesse, Bellafill) and Sculptra. This would allow you to try on the look before committing to a permanent option like fat or implants. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Nirmal Nathan, MD · Answer

Needneed, what you describe will happen as the temporalis muscle was likely injected to reduce use of your TMJ join. The muscle will atrophy and give a skull like appearance. You can try filler to compensate for it but it is a poor substitute for your actual muscle, in my opinion. I would recommend consulting with a board certified plastic surgeon for further input.

Daniel Barrett, MD · Answer

Dear needneed,if you are considering a treatment, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Melvin Elson, MD · Answer

Botox does work very well for TMJ but the injections are into the muscle that also gives some form to your face and it can get somewhat smaller termporarily. it does not matter whether the muscle is hyperactive or not

Leonard Grossman, MD · Answer

The effect of Botox is such that it only affects the muscles that are hyperactive and in such a way one can get rid of TMJ pain as well as migraine headaches or tension headaches. The fact that you're getting thinner and thinner in the face has nothing to do with botox. You need to be evaluated either by at least your family physician or plastic surgeon like myself to determine as to why your face is becoming so skeletonized. You should have submitted a set of photographs but without them I can't give you more help than that. Good luck from New York City

Kristine Brecht, MD (license suspended) · Answer

Botox can help with TMJ symptoms, but it can also cause atrophy to the muscle.You can always put fillers in the area where the volume is deficient.Discuss the issue with your injector.Choose an expert. Best. Dr BrechtSeattle, Wa

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