Will a lot of TMJ botox cause severe hollowing of the jaw? (photos)

Question

I received 25U on each side around 3 months ago and the slimming was great. However recently noticed the slimming effect was wearing off slightly, more so on my right side. I went back to my practitioner and they said it was fine to get TMJ injections at 2 month mark, she did 15U on my left and 20U on my right. I’m getting worried that I’ll get severe hollowing of the face (I saw a girl on Youtube experience this). I’m 28, 120lbs. I’ve had TMJ over a year ago so not my first time

Jonathan Kulbersh, MD · Answer

Hello, and thank you for your question. While every patient is different, the majority of men and women are able to enjoy the results of masseter Botox injections for up to six months. Your provider should be able to recommend the best time for touch-ups depending on your needs, goals, and how you respond to Botox. I recommend only seeking treatments from reputable board-certified facial plastic surgeons, particularly those with extensive experience with injectables. These experts will know how much to use and where to inject Botox to achieve natural-looking results. They will also work with you to create an appropriate treatment plan to safely maintain optimum results.

Theresa M. Jarmuz, MD · Answer

The Masseter is treated and it is a muscle. It is only weakened by the Botox, but it is not eliminating function. The bulk of the muscle will decrease, but it is still there and contributing to the shape and volume of your face. That muscle will increase in size again if you stop Botox or space out the treatments. I suggest only using the amount of Botox needed to lessen your TMJ pain and keep the intervals, of injections, longer to allow time for muscle re-growth. With normal treatment doses and proper timing of treatment, you should not have facial "hollowing."J Scaljon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs. I would not expect you to suffer with extreme hollowing of the jaw, remember if you allow Botox to wear off the muscle will return closely to your original size.

Akshay Sanan, MD, FACS · Answer

For botox to the masseters, treatment every 3 months is sufficient for the first couple treatments. The masseter muscles then require maintenance treatment spaced every 6 months apart. Every patient is different and requires different dosing and different intervals. It takes a couple treatments to figure out what your dosage is, if one masseter requires more than the other, and your interval. It's important to see a board certified physician for your treatments.
All the best,Dr. Sanan, MDFacial Plastic SurgeryLos Angeles, CA

Camille Cash, MD · Answer

From your photos it does not appear that your Botox injection will result in extreme hollowing.  The masseter muscles do appear to be slimmed, but not excessively so.  The product effects will wear off gradually over three to four months.

Will a lot of TMJ botox cause severe hollowing of the jaw? (photos)

Answers (5)

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