Can botox in the masseter muscle migrate to the eyelid muscle (levator)?

Question

I have TMJ and related masseter muscle enlargement and would like to get botox to relieve pain and shrink the enlarged muscle. However, I had congenital eyelid ptosis correct a few years ago and I am nervous about botox due to the worry of it affecting my eyelids. I will never get forehead botox because of this, but would like to know if botox injected ONLY in the masseter muscle could migrate to the eyes? The dermatologist i saw said it is impossible but would like second opinions.

Anna Chacon, MD, FAAD · Answer

I completely understand why you're asking this, especially after having surgery to correct congenital eyelid ptosis. It's reasonable to be cautious when your eyelids are something you've worked hard to correct.

The reassuring news is that Botox injected only into the masseter muscle is very unlikely to affect the levator muscle that lifts the eyelid. These muscles are located in completely different areas of the face. The masseter sits along the angle of the jaw, while the levator muscle is deep within the upper eyelid. Because of that distance, Botox injected correctly into the masseter does not typically migrate far enough to weaken the eyelid muscles.

When eyelid drooping occurs after Botox, it's almost always associated with injections placed around the forehead, glabella ("11" lines), or brow, where the medication is much closer to the muscles responsible for lifting the eyelid. That is a very different situation from masseter treatment.

That said, no medical procedure is ever entirely without risk. Technique, dose, and injection depth all matter. When Botox is placed appropriately into the masseter by an experienced injector, the risk of it affecting your eyelids is considered extremely low.

Since you have a history of congenital ptosis repair, it's also helpful to let your injector know about your surgical history. While it doesn't necessarily prevent you from receiving masseter Botox, it does encourage a more thoughtful and conservative treatment plan.

For TMJ-related pain and enlarged masseter muscles, Botox can be an effective option for reducing muscle tension and, over time, decreasing the size of the muscle. Based on what you've shared, your concern about eyelid drooping is understandable, but Botox confined to the masseter muscle would not be expected to weaken the levator muscle or recreate your previous ptosis.

Can botox in the masseter muscle migrate to the eyelid muscle (levator)?

Answers (1)

More Botox for TMJ Questions

Can Botox fix jaw misalignment? (Photo)

Got masseter botox, lost definition in face what can be done? (Photo)

Daxxify for TMJ — When to repeat and concerns about injector technique?

Is it possible for masseter Botox to cause lasting harm to nerves or muscles?

Does everyone eventually develop resistance to Botox?

Would Botox help to improve my facial asymmetry? (Photos)

WE SEND PRETTY
EMAILS