How to avoid lopsided smile after botox to masseter?

The benefits of Botox for facial shaping depend on the location of injections, the amount of product injected and the reconstitution of product used. The side effects of Botox depend on the same three things. In short, these things depend on the experience of the injecting doctor.When choosing you Botos doctor, look for someone who does it often and has lots of Botox experience.I hope that helps and best regards, Dr. Sapijaszko.

If you had this problem after three different doctors did it, then either none of the doctors are experienced in this procedure (very possible) or you have some aberrant anatomy. The percentage of people that have this issue is quite low in my experience - I recall about 5 patients out of 20,000 over the last 15 years, so it's not at all common. I would generally stick with Botox by allerghan, as it has the lowest amount of product dissipation. One version of botulinum, Myobloc, has the widest dispersion rate of product and I would avoid that particular brand for this use.

This is related to the persons experience and injection technique, not the toxin.  Go to someone who performs these injections often.  Injections into the masseter if proper, should only create an issue (if there is one) from biting down and have no effect on the corners of the mouth (different muscles control that).  Best, Dr. Emer.

When properly performed, Botox for masseter reduction should not affect the smile at all because it is injected directly into the body of the masseter muscle only.  While you may have seen 3 excellent physicians, it seems as though you may have received less than excellent treatments. Finding a physician experienced in Botox for masseter reduction will ensure the best results without side effects.  

Hi Allison. It is definitely unusual to have the same adverse effects to your smile with 3 different injectors. Even though a doctor is board certified, if they do not have experience injecting the masseter muscle then complications can occur. Usually an altered smile after Botox to the masseters is because of improper placement, or migration of the Botox. I take several safeguards to prevent things like this from happening when I inject the masseter muscle. Two things that will help greatly are to stay posterior when injecting the muscle, and inject deep into the muscle. Make sure your doctor is experienced in performing these injections. Hope this helps.

Hi Allison.  This seems unusual since the injection of the Masseter is pretty straightforward.  Perhaps there is something unique about your facial muscle structure, but one of the ways in which we avoid this issue is diligent before and after pictures so that we can document any changes to the smile like you mentioned and adjust the treatment if necessary.  For examples of Masseter injections in Venice, CA, click the link below.  

Typically using a longer needle than usual will help avoid that.  Board certification is a great thing to have but that doesn't always ensure experience in all fields. The most predictable way is to use a moderate strength concentration of Botox.  Use a 30g needle one inch long.  Clench the muscle and inject closer to the insertion at the angle of the mandible where most hypertriphy occurs  

This is a common complaint when the classic method is used and therefore if the doctor will not inject the medial aspect the masseter will still taper and you will be able to smile