Masseter muscle Botox? Any experience with this? How long to get results and with how much Botox?

Question

Hi, I heard from a friend that some people are getting large dose masseter Botox injections over a period of time to induce some masseter atrophy leading to slimming appearance of lower face. Any experience with this? How long to get results and with how much Botox? Does this cause a hollowing or sunken cheek look? Also any issues with facial nerve injury?

Jerome Edelstein, MD · Answer

Hello, Thank you for your question. Should you be a candidate for this treatment, your jawline can be gently reshaped to make it less angular and prominent, narrowing the contour of your lower face to create a more feminine appearance. The Botox, injected in both sides of the jaw, will selectively relax the masseter in the days following your injection, gradually making it less prominent and square. The width of your jawline may slowly narrow, transforming your facial shape into more of an oval or heart. Optimal results may take up to four to six weeks to appear, but can last for up to a year depending on lifestyle habits. To maintain results, you’ll need touch-up injections most likely scheduled twice a year. I recommended that you book a consultation with a qualified injector to discuss your options.  For hallowed cheeks, this typically involves the surgical procedure of buccal fat removal. All the best.

Brian S. Biesman, MD · Answer

Botox is a great option to slim the face if the masseter muscles are large and causing bulging.  Botox injection of the masseter muscles can also help decrease grinding of the teeth at night and even symptoms of TMJ in some patients.

Mariusz Sapijaszko, MD, FRCPC · Answer

Botox is great for face slimming and we have been doing it for over 10 years. Generally speaking, larger doses of Botox are needed and the injections must be precise so not to cause problems with smile muscles.Please make sure that you seek an expert physician for a consultation and assessment prior to proceeding with the treatments.Best regards and I hope that helps, Dr. Sapijaszko.

Sheila S. Nazarian, MD · Answer

Yes, Botox can help with slimming down a large jaw, but it's going to take multiple sessions and unlike Botox on say, the forehead, the results will be more gradual. I would suggest that you schedule a consultation with a board certified plastic surgeon or cosmetic dermatologist in your area (link below) to discuss your options. Best, Dr. Nazarian

Houtan Chaboki, MD · Answer

Yes, Botox and similar treatments can be used to narrow an excessively large jaw. Unlike wrinkles around the eyes and forehead, Botox for the lower jaw takes longer to appreciate results. Generally, patient will gradually notice a difference in about a month, unlike a few days for forehead wrinkles. On the other hand, results last longer, about 4 to 6 months before jaw muscle get big again.If you haven't already, then speak with a plastic surgeon or dermatologist to determine if Botox is appropriate for you.Best,Dr. Chaboki

Robert M. Tornambe, MD · Answer

Physical exam and/or photos would be helpful, but Botox can be used to effectively reduce the size of the Masseter muscle, and slim the appearance of the face, especially in people with large Masseter muscles, frequent in the Asian population. Several treatments are required and best to start off conservatively. Seek out an expert injector, like a board certified plastic surgeon, with intimate understanding and knowledge of the anatomy of the Masseter muscle. Good luck!

Steven J. Pearlman, MD, FACS · Answer

This is one of the most common uses for Botox in Korea. Botox relaxes the master muscle that sits along the corner of the jaw. It usually lasts around 6 months, a little longer than in the upper face. The cheeks should not get hollow since Botox stays where it is injected. As for dosage, we start low and increase the dosage as needed. The facial nerve is never "injured" but rarely this nerve can be affected, altering the smile for a few months.

Lee B. Daniel, MD · Answer

Yes, Botox is injected in our office daily. The masseter does require larger doses of botox to cause atrophy. When injected in this muscle it does take longer to notice slimming affects.

Steven Wallach, MD · Answer

Botox use in the master often requires more than one treatment to see the effects.  Best of luck with your decision to move forward.

Luis Soro, DO · Answer

I do this often for patients with bulky masseters looking to slim the lower face or for patients who often clench or grind their teeth. It is very well tolerated and is usually just a few injections per side. The average amount used is 15-20 units per side but can vary depending on the degree of hypertrophy. It typically takes more than 1 treatment for the slimming effect to be appreciated. This does not cause any hollowing of the cheeks in my experience nor does it pose any risk to the facial nerve if done by an experienced injector.

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