Can you hit a nerve while injecting the masseter muscle?

Question

I had Botox of the masstier muscle 5 days ago 26 units in each side by a board Certified plastic surgeon in Beverly Hills. My right side has 0 pain. My left side however hurt really bad in one of the injections and after for the first three days it was throbbing deep into that muscle to my ear and down that side of the neck. Now it hurts on and off especially when i sleep on that side? Could the plastic surgeon hit a nerve is this going to be permanent? Any thoughts? Thank you!

Michael I. Echavez, MD · Answer

From your description, I think it is unlikely that any nerve was hit during the Botox injection into your masseter muscle.  It is possible the muscle itself was hit and just got a bit of a bruise below the level of the skin.  In this case, some pain on that side would be possible even though a bruise may not be visible on the skin.  I would expect your issue to resolve completely fairly soon.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question and I am sorry to hear of your symptoms. It sounds as if either a bruise or muscle irritation occurred during your injections and this should improve given additional time.  Hang in there and inform your injector of your discomfort.  They can provide you with additional reassurance.

Melvin Elson, MD · Answer

Although it is always possible to hit a nerve with injection, the most likely reason for your discomfort is a bit of bleeding into the muscle which will completely disappear on its own

Leonard Grossman, MD · Answer

Chances are very small that a branch of a nerve was hit but it is possible. The most likely scenario is that you have a small bruise in the muscle and it will continue to hurt until it's resolution. Applying moist, warm compresses will help quite a bit. Good luck for New York City

Michele S. Green, MD · Answer

It is possible that the Botox irritated a nerve or hit a muscle and lead to the pain that you are experiencing.  I would return in a week to your treating physician for examination.  Botox injections in the masseter is a higher injection skill and I would consult an expert in that area.  Best, Dr. Green

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Can you hit a nerve while injecting the masseter muscle?

Answers (7)

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