Masseter Botox Is the Injectable Form of Stress Relief Everyone is Talking About

Turns out, the uncertainty and stress of the last few years have presented themselves in our jaws. Masseter Botox, or Botox injected into the jaw's masseter muscle to shape the area or to relieve tension, is a topic of a lot of conversation lately, especially on TikTok. Right now, videos — of jaws before and after reshaping with masseter Botox and clips of people swearing by the procedure's ability to calm their sore jaws —  have upwards of 50 million views. 

The interest in the noninvasive procedure isn't exactly surprising to a lot of dermatologists and plastic surgeons. A 2020 study found that stressed people experience a staggering 97 percent higher chance of developing bruxism, a condition in which you grind or clench your teeth, which can result in the masseter muscle being overworked. And if you're wondering what constitutes a stressed person — because isn't that kind of everyone? —  the scientists defined stress as "a condition or feeling experienced when a person perceives that the demands placed on them exceed the resources the individual has available." (Again we say… everyone?)

A lot of us don't even realize we're clenching our jaw when we're stressed. It can happen during the day when you're feeling overwhelmed (and this can quickly become a habit) or at night. If you're someone who notices jaw pain as soon as you wake up, you could be a midnight teeth-grinder. And "masseter Botox can be known as teeth-grinding injections," says Ash Soni, MD, a plastic surgeon in London. "The masseter jaw muscle enlarges when people clench or grind their teeth." And that enlarged muscle starts to hurt, which can, in turn, cause headaches, too. When this happens, many people seek help from their dentist, who often suggests wearing a night guard to protect teeth along with jaw exercises. And these solutions can be just fine and simple enough fixes for a lot of people. But if you're a daytime clencher who's not keen on the idea of wearing a night guard 24/7, you might need additional help. That's where the injections come in.

Injections of Botox every three to eight months into the masseter muscle on both sides of the jaw can relax the muscle and reshape the jaw in the process. "Many patients are seeking both benefits because they have a hypertrophy or enlargement of the masseter muscles from grinding their teeth," says Melissa A. Doft, MD, a board-certified plastic surgeon in New York City. "This makes the face look wider, but also leads to jaw tension. Botox treats both."

Ahead, with the help of experts, we dive into exactly what masseter Botox is, the pros and cons, and whether you might be a good candidate for it. 

Meet the experts:

  • Melissa A. Doft, MD, is a board-certified plastic surgeon in New York City.

  • Shari Marchbein, MD, is a board-certified dermatologist in New York City. 

  • Ash Soni, MD, is a plastic surgeon in London. 

In this story:

  • What is masseter Botox?

  • But wait, what is the masseter?

  • What are the benefits of masseter Botox?

  • How is masseter Botox performed? 

  • What is recovery like for masseter Botox?

  • What are the risks of masseter Botox? 

  • What is the cost of the procedure? 

  • Masseter Botox: the TL;DR

What is masseter Botox?

First thing's first: While the treatment is commonly referred to as masseter Botox, it's also true that Botox is a brand name for just one neuromodulator used for this treatment. It can also be done with Jeauveau, Dysport, Xeomin, and Daxxify. Injecting any of these neuromodulators into the masseter muscle is an off-label use of botulinum toxin, meaning the Food and Drug Administration (FDA) hasn't approved injecting botulinum toxin in the jaw, but injecting neuromodulators off-label is very common: They're FDA-approved for use in areas such as the 11 lines between the brows and also for forehead lines (different neuromodulators may be approved for different areas), "but we routinely use neurotoxins to help with a downturn of your smile, to treat hyperhidrosis [excessive sweating], and the masseter muscles," says Dr. Doft.

But wait, what is the masseter?

The masseter is the very powerful muscle along your jaw that helps you chew. "Many of us have temporomandibular joint disorder (TMJ) or jaw soreness because we clench," says Shari Marchbein, MD, a board-certified dermatologist in New York City. The masseter becomes enlarged, you get painful jaw aches and headaches, and the look of the jawline can even shift, getting wider.

What are the benefits of masseter Botox? 

The two main benefits of masseter Botox are released tension in the muscle and a reshaped jaw. The two often go hand in hand, with most people seeking both results. 

Here's how it relieves soreness: When Botox is placed correctly into the masseter muscle, "it essentially stops the muscle from contracting and causes that muscle to shrink in size (a process called atrophy), over time," says Dr. Soni. "As this happens, it gives almost instant symptom relief" and your jaw should feel more relaxed.

And because Botox doesn't completely paralyze the jaw's muscles, you'll still be able to chew normalyl. "There are many muscles which contribute to moving the jaw and Botox is only targeting the masseter," says Dr. Doft. Plus, “the dose is not high enough to completely eliminate the function of the masseter.”

The experts we talked to say masseter Botox should be used alongside other treatments that relieve tension (like stretching techniques), stress management, and booking a dentist appointment to have a night guard fitted, if necessary. Often masseter issues require a holistic approach because there can be multiple causes. You might be stressed. You might have TMJ caused by your genetics. You might simply just grind your teeth while you sleep.

Here's how it reshapes the jawline: Neuromodulators "decrease muscular contractions, so when we don't allow muscles to move, it thins them over time," says Dr. Marchbein. "It's kind of like if you go to the gym and you're doing curls to work out your biceps. If you stop doing curls, your bicep is not going to be as big." 

If you're going to your dermatologist's office for either — or both — reasons, it's also good to know that because Botox is being used off-label, it impacts your payment options and will not be covered by insurance (more on this later).

How is masseter Botox performed? 

First, your dermatologist or plastic surgeon will examine you to make sure you're a good candidate for masseter Botox, in other words, that your masseter muscle is enlarged or you have TMJ, and you’ll likely need to have a dental exam to determine this. (And if you’re pregnant or breastfeeding, you should avoid Botox completely.)

Once you've been given the go-ahead, your practitioner will examine your jaw in greater detail. Your doctor may ask you to clench your teeth "and then we draw out the masseter," says Dr. Marchbein. 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 afterwards. I just say avoid heavy drinking the same night to minimize any chance of bruising, but that's literally it," says Dr. Soni. 

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, "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 potential 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. It might be treating the superficial portion of the masseter and not the deeper portion of it [causing the bulging]."

Before choosing your provider, do research to make sure they have adequate experience in the procedure. You're well within your right to ask questions, like, How long have you been doing masseter Botox? or Do you have any before and afters and testimonials I can see? to make sure ithe doctor is the right fit for you. 

What is the cost of the procedure? 

As with many injectable procedures, the cost really depends on your location as well as the way a practitioner charges for treatments. Some injectors charge by units of neuromodulator, while others have different fees for different areas of the face. On average, masseter Botox costs between $750 and $1,000. Since it's an off-label treatment used for aesthetic purposes only, this isn't a claim that you can submit to insurance.

Results last around six to eight months, according to Dr. Soni (although some patients can metabolize Botox in just three months), at which point you'll have to re-up masseter Botox to maintain the benefits be they a reshaped jawline or tension relief. 

Masseter Botox: the TL;DR

Just because masseter Botox is commonly performed, that doesn't mean it's for everyone. Dr. Marchbein goes on to say that it's best for those who have painful or uncomfortable symptoms caused by clenching or grinding their jaw, like TMJ. "But just for people who want to change the shape of their face, I don't necessarily recommend doing it," Dr. Marchbein says. She goes on to say that because the masseter muscle sits on the angle of the jawline, those who want to use it to slim the face may experience skin laxity that may require jaw filler to correct.

For more information on Botox: 

  1. What Is Daxxify, and Why Would I Want to Inject It in My Face?

  2. Black Americans Are Getting Botox More Than Ever

  3. What Is Hair Botox and Why Is Everyone Talking About It?

Want to know more about how fillers works? A dermatologist explains: 

Originally Appeared on Allure