Botox Jaw Reduction

Botox jaw reduction is a safe, effective and long lasting treatment for individuals with bilateral masseter hypertrophy.

Masseter Reduction

Masseter muscle hypertrophy presents as a tissue enlargement at the angle of the jawline. Hypertrophy describes an increase and growth of muscle cells as the result overactivity. While masseter hypertrophy is more common in certain ethnic groups, it can result in facial pain, headaches and appear cosmetically unsightly.

Masseter hypertrophy can also result from bruxism.

Bruxism is a medical condition where an individual would unconsciously clench and grind their teeth. This can happen during daytime and while asleep. In addition to masseter hypertrophy, individuals may suffer from facial pain, worn out teeth, jaw dislocation and other dental problems down the road.

botox jaw slimming

What Causes Masseter Hypertrophy?

The underlying causes of masseter hypertrophy are numerous, and factors affecting an individual may differ from another. From dietary habits such as the propensity at chewing nuts or hard foodstuff, masseter hypertrophy may also result from genetic factors. 

While the causes of chronic bruxism remain unknown, stress, and abnormal masseter muscle function may play a role. Some studies postulate that the enlargement may be due to a compensatory lack of certain muscle fibers.

How To Diagnose Masseter Hypertrophy?

While most cases of masseter hypertrophy can be made on clinical grounds, some cases do require further evaluation. Imaging such as MRI or CT scans may be used in some cases to confirm clinical suspicion. In addition, studying the muscle activity and muscle thickness using electromyographic and ultrasonographic studies respectively may be utilized. A muscle biopsy is rarely needed except in unusual circumstances.

Masseter Reduction Treatment Options:

There are variable masseter reduction treatment options, each with its benefits and potential side effects. When considering the most appropriate treatment, you would need to determine if the treatment fits with your lifestyle choice, tolerance and budget. Treatment options include:

  1. Drugs e.g. muscle relaxants, anxiolytics and anti-depressants
  2. Dental intervention for correction and prevention
  3. Botulinum Toxin A injections to the masseter muscles
  4. Radiofrequency volumetric reduction
  5. Surgery 
masseter reduction with botox in Singapore

How does Botox Jaw Treatment work?

The main action of botulinum toxin treatment is to inhibit activation of the masseter muscles. A period of muscle inactivity will lead to muscle atrophy (smaller muscle mass). This reduces the facial angle and gives rise to a slimmer and more contoured lower face over time. There are some studies to suggest that the weakened masseter muscles will lead to changes in the mandibular bone. This means that the dramatic effects from this treatment are not only due to a reduction in muscle bulk, but also changes in the jaw bone structure. 

How Is The Procedure Done?

After a consultation, a clinical examination will be carried out to determine suitability for the procedure. You will be asked to clench your teeth to accentuate the masseter muscles on both sides. After cleansing the area, and applying numbing cream, 3-5 injections are placed into the bulkiest portion of the masseter muscles. You are advised not to lie down for 4 hours post-procedure, avoid alcohol for 72 hours, and repeatedly clench your teeth for 20 minutes after the procedure to maximise the treatment effects.

How long do the results lasts?

Most individuals will be able to notice modest results by 6 weeks. The results lasts for at least 6 months, but varies among individuals. It is important to reduce excessive and habitual chewing so that you get longer lasting results. Repeated treatments will bring about longer results as the muscles are already weakened.

Who Is A Good Candidate For Botox Jaw Reduction?

Individuals whose primary concerns stem from bilateral masseter hypertrophy would be most suitable. A consultation and clinical assessment must always be done first before any treatment is carried out.

Who Is Not A Good Candidate For Botox Jaw Reduction?

  • Pre-existing medical conditions causing muscle weakness e.g. multiple sclerosis, myathenia gravis
  • Infection at injection site
  • Previous allergy or hypersensitivity to Botulinum Toxin treatments
  • Pregnancy or breastfeeding

When Can I See The Results?

Owing to the large bulk of the masseter muscles and the onset of muscle atrophy, noticeable results are apparent between 4-6 weeks onwards.

For individuals with chronic bruxism, a reduction in symptoms may be felt within 1-2 weeks.

What's the Difference Between Botox and Dysport?

They are both Botulinum toxin Type A products which function to reduce neurotransmitter to the target muscle. There is not much clinical difference between them except:

  • Different units. 1 Unit of Botox is about 2.5 units of Dysport
  • Pricing. Dysport tends to have a more favourable price.
  • Diffusion. Dysport may be able to diffuse along a wider area which is advantageous to the bulky masseter muscle.

Besides these differences, the onset of action, longevity of effects and even side effects profile are similar.

How many units do you use?

We have a variety of botulinum toxins that can be used effectively for masseter reduction facial contouring. There is very little clinical difference between the major brands in terms of treatment results, and longevity of effect.  The amount of units injected will depend on your masseter muscle bulk. For individuals starting the procedure for the first time, we advise starting with a moderate amount. This will achieve good results in the majority of cases.

To get an idea of how much botulinum toxin we use, here is a rough guide. For Botox brand, we use on average 24-30 units per side. For Dysport brand, we use about on average 60-75 units per side. The amount varies from person to person. Generally, men and individuals with moderately-severe masseter hypertrophy would require more units. Please contact us for more details on the pricing.

Are there any side effects?

The Botox jaw reduction treatment is a non-surgical procedure which is safely performed in the clinic setting. Mild and temporary swelling, redness and bruising will subside in a matter of days. You may notice some weakness of chewing, especially foods of hard consistency, but this is often mild. Uncommon side effects that may be encountered include smile asymmetry. This usually happens if too much botulinum toxin is injected. We advise a gradual approach for individuals new to the procedure.

Is Botox Jaw Reduction Painful?

A numbing cream is applied to maximize your comfort. Injections are strategically placed at the bulkiest part of the masseter muscles. We use small caliber needles so that the treatment process is almost pain-free.

Can I Do Botox To Other Areas Too?

Absolutely. Botulinum toxin for cosmetic treatment utilises only small doses so it is safe in trained and experienced hands.

Will My Chewing Be Affected After The Procedure?

This is quite uncommon. The muscles involved in chewing not only depend on the masseters but also the temporalis muscles (muscles located on your temples). Any initial weakness in chewing would usually resolve in a few weeks.

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References:
  1. Ahn J, Horn C, Blitzer A: Botulinum toxin for masseter reduction in Asian patients. Archives of Facial Plastic Surgery. 6:188191 2004
  2. Chang CS, Bergeron L, Yu CC, et al.: Mandible changes evaluated by computed tomography following Botulinum Toxin A injections in square-faced patients. Aesthetic Plastic Surgery. 35:452455 2011Epub 2010 Nov 20
  3. Tsai CY, Shyr YM, Chiu WC, et al.: Bone changes in the mandible following botulinum neurotoxin injections. European Journal of Orthodontics. 33 (2):132138 2011 Epub 2010 Sep 30
  4. Wu WT: Botox facial slimming / facial sculpting: the role of botulinum toxin-A in the treatment of hypertrophic masseteric muscle and parotid enlargement to narrow the lower facial width. Facial Plastic Surgery Clinics of North America. 18:133140 2010
  5. Jin Park Y, Woo Jo Y, Bang SI, Kim HJ, Lim SY, Mun GH, et al. Radiofrequency volumetric reduction for masseteric hypertrophyAesthetic Plastic Surgery 2007;31(1):42‐52.
  6. Fedorowicz, Zbys et al. “Botulinum toxin for masseter hypertrophy.” The Cochrane database of systematic reviews vol. 2013,9 CD007510. 9 Sep. 2013, doi:10.1002/14651858.CD007510.pub3
  7. Yeh, Y-TPeng, J-HPeng, H-LP, . Literature review of the adverse events associated with botulinum toxin injection for the masseter muscle hypertrophyJ Cosmet Dermatol201817675– 687https://doi.org/10.1111/jocd.12721