Your doctor will then examine your jaw in greater detail. They may ask you to clench your teeth, for example, says Dr. Marchbein. During this exam, she says she observes how bulky the muscle is while drawing lines along the jaw and from the ear to the corner of the mouth. These will serve as her guidelines for where to inject.
Some practitioners, like Dr. Soni, use a local anesthetic cream and ice on the area, others just go straight to injecting. If you’re particularly squeamish about needles, this is something to consider when choosing your injector.
You’re injected on both sides of the face and the amount of units used depends on your needs and your injector’s preferences. “I typically start with only 15 units per side,” says Dr. Marchbein. “I have patients who need 25 to 30 per side.”
Many dermatologists and plastic surgeons require a second visit after approximately two to four weeks to check on your progress and top-up if needed. Unlike fillers, Botox takes a while to work, so it may take a week or two to see (and feel) full results.
What is recovery like for masseter Botox?
If you go to someone who is highly skilled and uses a light touch, there will be minimal evidence that a needle has touched your skin. “You can do everything normally afterward,” says Dr. Soni. “I just say avoid heavy drinking the same night to minimize any chance of bruising, but that’s literally it.”
What are the risks of masseter Botox?
Since injecting a neuromodulator into the masseter muscle is not yet FDA-approved, there isn’t a ton of research into the long-term effects. But in terms of immediate side effects, pain or discomfort, and bruising at the injection site are fairly common.
“It’s possible that Botox [could be] injected too far forward in the muscle, which can cause things like drooling and issues with the smile muscles,” warns Dr. Soni. These side effects can last from a few weeks to months, depending on the person.
Another issue to be aware of is possible bulging of the jawline if the correct parts of the muscle aren’t injected: “Depending on how the neuromodulator is injected or where it’s injected, sometimes other portions of the muscle will kind of stick out and it almost looks wavy,” says Dr. Marchbein.
If this happens, it, counterintuitively, might be a sign you need to see your injector again for more neurotoxin. “If the masseter is so thickened, maybe the amount of units we started with wasn’t enough,” she says. “It might be treating the superficial portion of the masseter and not the deeper portion of it [causing the bulging].”