Does the Masseter Return to Its Full Former Size Once Botox Wears off in That Area, or Does It Take Time to "Build Up" Again?

Doctor Answers 6

Botox in the Masseter Muscle

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The idea behind Botox is that the more times you are treated, the more the muscles atrophy from inactivity, and therefore the muscle takes longer to "bulk" back up.  In most cases your muscle will regain full function and return to original size when treatments are permanently stopped. 

Kindest regards

Neil J. Zemmel 

Masseter muscle treated with botox for thinning a full face

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I am not aware of any study investigating the time in which it takes for the volume of the masseter muscle to regain its orginal size after Botox wears off, and determining whether this would take more time if someone has maintained treatment for a long while vs. just having one treatment. An expert in this treatment, such as an ENT physician, Dr. Andrew Blitzer, NYC, who deals with TMJ syndrome (jaw clenching) has a great deal of clinical experience about this treatment and has communicated with me that the masseter muscle returns to full volume in 4 to 6 months, the time depending on the dose used and the extent of atrophy the muscle developed initially after treatment.

Ronald Shelton, MD
Manhattan Dermatologic Surgeon
4.9 out of 5 stars 39 reviews

Does the Masseter Return to Its Full Former Size Once Botox Wears off in That Area, or Does It Take Time to "Build Up" Again?

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Does the Masseter Return to Its Full Former Size Once Botox Wears off in That Area, or Does It Take Time to "Build Up" Again?  That depends on how much Botox was used, how many times and the interval between Botox injections.  There are reported cases of the Masseter being made permanently smaller using repeated large doses of Botox.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Masseter takes time to build up again

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Botox weakens the masseter, which results in a slow atrophy of the muscle.  Once the botox wears off and the masseter regains its strength, it will bulk up again.  This takes time.  How much time depends on how atrophic the muscle is, as well as whether the patient clenches or grinds the teeth or chews gum.  These habits make the muscle bulk up more quickly.

Botox in masseter region

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Thank you for your question. Botox in the masseter region usually takes longer than in the standard areas to take effect. I tend to use anywhere from 15 units (conservative treatment) to 50 units (for someone with really strong masseters) on each side to get the desired result. It may start within the first week but I tell my patients to wait three weeks before doing a more thorough evaluation. The treatment typically lasts longer than the forehead/crows feet/frown regions. It is also a gradual onset of the return of masseter function. I have tried the masseter injections myself and space the treatments around 4 months apart, but use smaller doses to maintain the effect. I normally know the effects are wearing down when I start to clench my teeth more heavily at night when asleep.  Once you stop using Botox, the masseter muscles will return to their original baseline when the effects of Botox  wears off completely.

Botox & Masseter Muscle

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The Masseter muscle, as well as other facial muscles, may maintain good outcomes for a longer duration with repeated treatments.  However, only time and one's one pattern of animation and muscle contraction will determine how long they will maintain results without treatments.

Ideally, once receiving optimal results for the debulking of the Masseter muscle, a maintenance treatment once or twice a year may prove valuable.

The below link will lead to before/after photos and articles on this service.


Harold J. Kaplan, MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 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.