Asymmetric jaw muscles (masseters) from grinding? Will Botox help or do you believe this to be a bone asymmetry? (Photos)

Question

For the last 4yrs I had a habit of voluntary grinding my teeth on only the left side. About 2 years ago I began to notice the left side of my jaw and upper cheek have appeared thicker. Recently, I spoke to my dentist and she noticed it right away and said my cheek felt thicker on the left side. She said I had clear grind marks on my bottom teeth. I looked at pictures that are 4 yr old and my face appears symmetric. Would Botox help since I have stopped grinding or is this more so bone asymmetry?

Philip S. Schoenfeld, MD, FACS · Answer

You are really asking two questions.  The first questions deals with the efficacy of Botox on Masseter muscle hypertrophy and facial asymmetry.  I practice in Washington, DC and many people grind their teeth so I have the opportunity to perform a great deal of Botox injections to the masseter muscles to reduce the strength of the clenching.  One of the benefits of these injections is that is also can reduce the size of the muscle much like if you stopped working out your biceps they would also reduce in size.  From the photos that you have provided I do not think that your facial asymmetry is 100% due to masseter hypertrophy.  I think, like all of us, you have some facial asymmetry that is not due only to muscle hypertrophy.

Aldo Guerra, MD · Answer

I appreciate your question. It looks like hypertrophied muscles which should respond nicely to Dysport it Botox. See the video below!Dr. Aldo

Houtan Chaboki, MD · Answer

Botox and Dysport work by relaxing muscle. These office treatments may be used to sculpt the face, especially for patients who may have large muscles. Unlike Botox for forehead wrinkles, results with sculpting develop gradually over several weeks. Read more via link below and several before/after photographs. Best,Dr. Chaboki

Philip Solomon, MD, FRCS · Answer

Thank you for your question and pictures. Grinding your teeth can certainly enlarge your masseter muscles.  Botox is great at relaxing the masseter muscles and slimming the face. An in person examination is best to determine is the mandible itself has asymmetry.  Dr. Solomon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Teeth grinding can certainly contribute to enlargement of the jaw muscles to lead to some mild asymmetry between the right and left sides of the face and this typically responds well to Botox placement.  An in-person examination would need to be performed to determine if your tissues are enlarged because of the muscle or the jawbone itself.  Hope this helps.

Jason Emer, MD · Answer

Yes, Botox combined with radiofrequency can help slim the jawline and improve symmetry. I recommend getting a formal evaluation with a facial sculpting expert. Best, Dr. Emer

Justin C. Cohen, MD, FACS · Answer

It's highly unlikely that you developed bony asymmetry in the last four years. Muscular hypertrophy in response to grinding is common and typically responds to Botox therapy. Good luck!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  If you have masseter hypertrophy, botox injections can be helpful.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Kevin Tehrani, MD, FACS · Answer

Thank you for your detailed question and corresponding photo. Yes, Botox can be used to help teeth grinding in patients who have pain or a strong visible masseter muscle. I would start with at least 25 units into the left jaw and see if that makes a difference for you over the course of 3 months, we could always go up on the dose at the next treatment until we figure out what dose is perfect for you. I recommend seeing a board-certified plastic surgeon or expert injector in-person to examine your muscles and treat you appropriately. At our practice, we also provide consults via FaceTime or Skype for patients who live outside of NY. For more information, please visit our webpage.

Sean W. Delaney, MD · Answer

Most people have minor asymmetries between the two sides of their face. Botox injected into the masseter muscle can help slim down the muscle and generally lasts 3-4 months. Botox is also great for treating individuals with teeth grinding (Bruxism) or TMJ problems. Your photographs suggest possible asymmetry of your facial bony structures. While Botox works well on muscles, it does not alter the underlying bony structures. I recommend in-person examination to determine the sources of your facial fullness and whether you would benefit from Botox injection into the masseter.

Asymmetric jaw muscles (masseters) from grinding? Will Botox help or do you believe this to be a bone asymmetry? (Photos)

Answers (17)

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