Bulging masseter muscle after Botox, is this normal? (Photos)

Question

Three days ago I received 25 units of Botox injected into each side of my masseter muscles. Yesterday, I noticed that when I clench down there is a significant protrusion of my masseter muscle that wasn’t present when I clenched down prior to getting Botox. I do have some soreness and weakness in the area when I chew. Is this a normal reaction? I left a message with my injector but have yet to hear back. I would appreciate any input regarding this issue. Thank you!

Steven H. Williams, MD · Answer

Hi,Thank you for your question.I would recommend waiting the full 2 weeks and re-evaluating with your injector at that time to determine if additional units are required for any undertreated fibers. Botox takes 2 weeks for the full effect. Some soreness and weakness at the injection site 3 days after is normal. Cool compresses can help with the soreness.Hope this helps!

Jonathan Kulbersh, MD · Answer

While this may be due to Botox placement, it can take up to 2 weeks for your final results. I would wait a full 2 weeks before assessing results. Hope this helps.

Monika Soni, MD · Answer

What has happened is that the superficial muscle fibres have been paralysed, meaning the deeper fibres can push out more. This can happen with masseters, if Botox isn't injected deep enough. However it may be that it just needs a bit more time to work on the deeper muscle. If it's still bulging in 2 weeks it might be best to get a deeper top up.

Blue Medi Spa - Sherman Oaks - Account Suspended · Answer

Since it has only been 3 days since you had Botox injected I recommend to wait 10-14 days for the Botox to fully settle in.  At that point if you still see a protrusion you may require more Botox to treat the deeper muscle.  Best of luck!

Mark Kearns, MBChB, BSc, FRACGP · Answer

Hi Emily!
What has happened is that the superficial muscle fibres have been paralysed, meaning the deeper fibres can push out more.
This can happen with masseters, if Botox isn't injected deep enough. However it may be that it just needs a bit more time to work on the deeper muscle. 
If it's still bulging in 2 weeks it might be best to get a deeper top up.

Bulging masseter muscle after Botox, is this normal? (Photos)

Answers (8)