Botulinum Toxin for the Masseter: Teeth Clenching and a Wide Lower Face
The masseter is a strong muscle located on the side of the face between the cheekbone and the lower jaw, and it is responsible for chewing. Botulinum toxin treatment of this muscle aims to temporarily reduce its strength of contraction. It may be considered in some people for complaints related to teeth clenching, and in others when an enlarged muscle makes the lower part of the face look wide. This article explains botulinum toxin treatment of the masseter, its limits and its risks.
When Is It Considered?
- Jaw muscle pain and tension associated with teeth clenching or grinding (bruxism)
- A prominent jaw angle and a wide-looking lower face due to an enlarged masseter muscle
Teeth clenching can have various causes related to stress, sleep patterns and the structure of the teeth and jaw. Botulinum toxin does not remove these causes; it only temporarily reduces the strength of the muscle. For this reason, a dental assessment and, where necessary, options such as a night guard are also important for people who clench their teeth. Width in the lower face is not always caused by the muscle; other causes such as enlargement of the salivary glands are distinguished at the examination.
How Is It Done?
The doctor first examines the size of the muscle and how it behaves when contracting, and assesses the complaints and expectations. The treatment area is cleaned; an anaesthetic cream is used if needed. Botulinum toxin is injected with a fine needle into selected points of the muscle; treatment is usually done on both sides. The amount and number of injection points are determined individually by the doctor. Daily activities can usually be resumed immediately after the procedure.
When Does It Start Working and How Long Does It Last?
The reduction in muscle strength usually begins to be felt within a few days. The change in facial appearance due to thinning of the muscle appears more slowly, over a period of weeks. The effect is temporary; muscle strength gradually returns, and the treatment can be repeated at intervals recommended by the doctor if needed. How long the effect lasts depends on the person, the strength of the muscle and the amount used.
After the Procedure
- It is recommended not to press on or massage the treated area on the first day.
- The period recommended by the doctor should be observed before intense exercise.
- Chewing may feel tiring in the first days; limiting hard foods and prolonged gum chewing may make this more comfortable.
Who Should Not Have It?
The treatment is not performed during pregnancy and breastfeeding, if there is an active infection in the treatment area, in neuromuscular diseases or if there is a history of allergy to the product's ingredients. Blood thinners and other regular medicines should not be stopped without asking a doctor, and the doctor performing the procedure should be told about them beforehand. Realistic expectations are important; the definition of the jawline does not depend on the muscle alone, and the bone structure does not change with this treatment.
Possible Risks
Pain, swelling and bruising at the injection site, headache and temporary weakness or fatigue when chewing may occur. Less commonly, asymmetry of the smile, an unexpected bulge in part of the muscle and, especially in people with loose skin, a sagging appearance in the lower face may develop. If difficulty swallowing, speaking or breathing, double vision or marked muscle weakness is noticed, a doctor should be contacted immediately. For more information, see our chin filler and bichectomy pages.
Author: Op. Dr. Yücel Sarıaltın