What is causing the crackling sound in my jawline after botox?

I inject the jawline or masseter muscles about 3-4 times a day and have never had a patient complain of this symptom.  Like your body joints (fingers, toes, kness) crack without any consequence, I assume the jaw can do the same.  If this continues after 10-14 days, then I would suggest speaking to your dermatologist or plastic surgeon.  Although, I have a feeling this is not related to the injections at all and is something that may have already been there but was never noticed until now.  Cracking in the TMJ joint which is near the ear, is something that would need to be evaluated by a maxillofacial or dentist, as to ensure you do not have dysfunction of that joint.  However, Botox of the masseter muscles, should improve this and it will take up to 14 days.  Best, Dr. Emer.

The idea that this is from Botox and not associated with other neuromodulators is unfounded.  There is no evidence in the literature to support this.  I have never had a patient with these symptoms from injections in this area, and I use Botox.  You may have some fluid or air in the area causing these symptoms.  You should see your injector to discuss.

This sound (as reported by my patients) seems to be much more common with Botox injections than with Dysport or other neuromodulators. It has to do with the actual nerves being affected by the Botox. It's not a problem and it stops very quickly. No one else can hear it. It's an internal sound only. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."