8 things to know before trying masseter Botox, according to aesthetic doctors

Masseter Botox has been much-discussed online in the past few years. Despite the recent increase in airtime, this has been a treatment for decades. And though the results are undeniable, it shouldn’t be booked simply because it’s considered on-trend – here, two doctors have shared the need-to-knows of masseter Botox.

In medicine, Botox is not only used to target the appearance of wrinkles (though this is arguably what it is best known for.) It is also a common treatment for the masseter muscles – which sit at the back of the jaw on both sides – for both aesthetic and medical reasons.

You may be here because you are just starting to research masseter Botox, or because you already think it could be beneficial to you. Above all, you should head into any appointment feeling confident in your practitioner and in going ahead with treatment. So, if you are considering it, here are eight things you need to know first, according to experts.

What is masseter Botox, exactly?

As mentioned, this is when Botox is injected into the masseter muscles to relax them. Dr. Sophie Shotter, founder of the Illuminate Skin Clinic, explains it can be used to treat a few different indications. “Firstly, it can be a very useful treatment for teeth grinding,” she tells us, adding that other muscles may also require treatment alongside the masseters in this case. “If someone is a teeth grinder, this can cause headaches, jaw pain and dental damage as the surface of the teeth is eroded.

“Aesthetically, it can also change the shape and height of the teeth. With repeated grinding the masseter muscle also tends to become bigger, making the lower face look bulkier and wider,” she continues. “Masseter Botox is also part of the treatment for TMJ (temporomandibular joint) disorder, which I would recommend having treated by a true specialist in this area – often a maxillofacial surgeon.”

What to know before getting masseter Botox, per aesthetic doctors

1. You must see a qualified and insured practitioner

We cannot stress this enough with any injectable treatment, from Profhilo to polynucleotides, and definitely in the case of Botox, which is a prescription-only medicine. This means that, by law, only a medical professional who is also qualified to prescribe (a doctor, dentist, or nurse prescriber) can prescribe you Botox. The medical professional does not have to be the one administering the Botox, but they must prescribe it to you in person – not over the phone or on a video call.

It’s also of paramount importance that you see a qualified and insured practitioner. This covers you both should anything go wrong for any reason. Medical training also means that your practitioner can treat you in the event of any medical complications. Years of experience are also a good indicator – the more years of injecting, the more practised the hand.

As well as researching the treatment, take time to research any practitioner and their clinic – which should be a clean, hygienic and professional setting – before booking in for a consultation. If something doesn’t feel official enough or you get a whiff of improper protocols, get out of there.

2. It’s not cheap

This is unlikely to be of great surprise to you, but Botox and other anti-wrinkle injections do not come cheap. (If the price sounds too good to be true, question why.) It may not seem like the cheapest deal, but seeing somebody qualified and very experienced – i.e. safe – will ensure your treatment is carried out safely and save you potential headaches further down the line. As masseter Botox requires injections in both muscles, you can expect to pay upwards of £250 in total for both sides of the face.

3. Results aren’t immediate

While it is possible to see a slight difference in the first few days, it usually takes weeks to see a real difference. Dr El Muntasar says you can expect to see results within two to four weeks. “The masseter muscle is a bulky and bigger muscle, so it takes longer for the Botox to settle in and start weakening it,” he explains.

4. You may notice your jaw feels a little weaker post-treatment

Botox works by weakening muscles, wherever it is injected, and so there is a chance you will notice a slight difference in the strength of your jaw. “Sometimes people can feel that their jaw and their bite in particular is a little weaker for the first few days,” Dr El Muntasar says. “There is always bruising and swelling of the areas that have just been injected and these may feel sore for a day or two. However, the needles that we use for Botox are like pediatric needles, so patients tolerate these very well.”

Dr Shotter also says that this shouldn’t be an issue with the optimum dose. However, “with over-treatment it is possible that chewing on the back teeth can become difficult. This is why I will always advocate a ‘less is more’ approach the first time we treat,” she explains. “We can always add more [Botox] at a review appointment, but once it’s in we have to just be patient and wait for it to wear off.”

“If someone injects too much Botox, you can actually [over] weaken the masseter muscle, which creates the risk of the patient's bite being affected for months alongside the stability of the TMJ,” Dr El Muntasar concurs. “This is why going for a proper consultation and assessment is paramount to ensure you feel 100% confident in going ahead with the treatment.”

5. It can make jowls look more prominent

It is possible that masseter Botox may exacerbate the look of jowls. “In someone with skin laxity, it’s possible that the reduction in volume caused by treating the masseter can make the jawline appear looser,” Dr. Shotter explains. This is why a consultation is so important before any treatment. Your practitioner may advise combining masseter Botox with another treatment or advise an entirely different option. A good practitioner will always tell you if you are unsuitable for any procedure.

“As with all medical treatments, there are risks,” Dr. Shotter continues. “But these risks should never outweigh the benefits, which is why it’s important to understand the reasons for doing this treatment. For those who suffer with tooth grinding, Botox can be life-changing.”

6. There may be longer-term effects

Any treatment comes with potential risks, which your practitioner will make you aware of before going ahead with treatment, as well as answering any questions or concerns you may have. Dr Shotter says that “it is a very safe and well-tolerated treatment” for most people.

Some research has suggested there could be longer-term effects resulting from repeated masseter Botox treatments, but more research is needed. “There are some studies with small numbers which suggest it may be possible that long-term use of Botox in the masseter muscles could lead to a reduction in bone density at the jaw,” Dr. Shotter tells us.”[However,] the reasons for this are not yet fully understood and there doesn’t appear to be any negative impact for the majority of patients.”

7. Your face shape may change slightly

Dr. Shotter notes that masseter Botox “is a very safe and well-tolerated treatment” for most people However, “Problems can, rarely, occur due to migration of the Botox – which can also affect the smile dynamics – or [as mentioned] due to over-treatment, which can cause difficulty with chewing.

“Occasionally it can also happen that some of the superficial fibres of masseter aren’t effectively treated and so, when someone clenches, a bulge appears,” she continues. “This can be very effectively remedied if you attend a review appointment with your injector.” Many people report a slight “slimming” effect due to the reduction in the size of the masseter muscles.

8. Results aren't permanent

If you know a little about Botox, you probably know that it wears off. The rate at which it does so can vary from person to person – and how much Botox was administered – but the results usually last for at least a couple of months. “I like to review patients between two and four weeks to ensure the result is optimal,” says Dr. Shotter. Then, “Results can last anywhere between three and six months.”

Dr. El Muntasar estimates results can last anywhere between two and nine months. “I would say the average patient comes back to see me two to three times a year for this particular treatment,” he adds.

The decision to have Botox shouldn’t be taken lightly, be it to target the masseter muscles or otherwise. I’m glad I tried it – and would most likely have it again due to the relief of tension in my jaw that I experienced – but you may end up deciding it’s not for you. In this case, we recommend reading our guide to alternatives to Botox, which includes some non-clinic treatment options.