Many patients ask, “Can masseter Botox slim my face?”, “Does masseter Botox help with TMJ?”, or “Can Botox reduce teeth grinding?” These are common concerns, especially for people who experience jaw tension, nighttime clenching, or feel that their lower face looks wide or bulky.
In this blog, we explain masseter Botox (also called masseter tox). We discuss how neuromodulators such as Botox, Dysport, Letybo, Xeomin, and Daxxify have been used in clinical practice to address overactivity of the masseter muscle. Our goal is to help you better understand whether masseter Botox for aesthetic goals such as jaw slimming, jaw contour, and facial harmony, or functional issues such as TMJ-related symptoms, teeth grinding (bruxism), is something worth discussing during a personalized consultation.
What is the Masseter muscle?
The Masseter is the name of a facial muscle. It is one of the main muscles you use to chew. It sits at the back corners of your jaw and activates every time you clench, chew, or grind your teeth.
What is Masseter Tox?
Masseter tox refers to the injection of neuromodulators deep into the masseter muscle on each side of the face. Common neuromodulators are Botox, Dysport, Daxxify, Letybo, and Xeomin.
Why Do People Get Masseter Tox?
In some people, the masseter muscle becomes very strong or overactive over time. This can happen for a variety of reasons, including teeth grinding or clenching, chronic stress, jaw tension, certain bite patterns, or even athletic training that builds muscle throughout the body. When the masseter muscles are overactive, patients may notice jaw soreness, headaches, or a persistent feeling of tightness. Some patients also notice that the lower face appears wider or more square. This appearance may lead some people to desire masseter tox for functional or aesthetic concerns.
Neuromodulators such as Botox, Dysport, Daxxify, Letybo, and Xeomin work by temporarily reducing a muscle’s ability to contract. For this reason, some providers offer neuromodulator injections into the masseter muscle with the goal of reducing excessive muscle activity and muscle size and/or improving the aesthetic contour of the jaw/cheek to achieve facial harmony.1
In our clinical practice, we have treated patients who seek masseter neuromodulator injections for different reasons, including for facial slimming of the jaw line, reducing jaw clenching, improving nighttime teeth grinding, and improving jaw-muscle related discomfort or for improving the aesthetic contour of the jaw/cheek to achieve facial harmony.
It is important to note that masseter tox has been studied, it remains an off-label use for all neuromodulators currently FDA-approved in the United States.2
What Tox Do You Use for Masseter Tox?
Typically, we have used the same neuromodulator the patient uses for treating other aesthetic concerns, such as forehead lines. Thus, whichever neuromodulator we have used on a particular patient – Botox, Dysport, Daxxify, Xeomin, or Letybo – will remain consistent for that patient. In other words, if we used Daxxify for forehead wrinkles, we also used Daxxify for a patient’s masseter injections as well.
How Do You Use Masseter Tox for Facial Slimming?
For patients pursuing masseter tox for facial slimming to improve the aesthetic contour of the jaw/cheek and achieve improved facial harmony, we typically administer neuromodulator injections every three to four months during the first year. After this initial period, most of our patients continue with maintenance treatments to help sustain the effect.
How Many Units of Masseter Tox Do You Use for Facial Slimming?
In our clinical practice, most patients seeking masseter tox for facial balancing have received approximately 10 to 30 units per side of Botox (or an equivalent amount of another neuromodulator). That said, dosing is highly individualized. Some patients have much larger or stronger masseter muscles and ultimately require higher amounts.
Even in patients with very strong masseters, we have taken a slow and conservative approach. The masseter is an important muscle for chewing, and using too much neuromodulator within a short time interval can lead to temporary difficulty with chewing or jaw fatigue. For this reason, we typically start with a lower dose and adjust gradually based on how the muscle responds.
How Do You Use Masseter Tox for TMJ or Teeth Grinding?
In our clinical practice, we often adjust the injection pattern over one or two initial visits to better understand how each patient’s masseter muscles respond. This stepwise approach allows us to fine-tune both dosing and placement, rather than over-treating the muscle at the first visit.
After this initial adjustment period, patients typically return to the clinic for additional injections when they initially notice their symptoms gradually returning. The timing of follow-up varies from person to person, but in our experience, patients who pursue masseter tox for TMJ or teeth grinding most commonly return every four months for the first year and then every six months after the ideal amount of tox has been properly optimized for maintenance dosing.
How Many Units of Masseter Tox Do You Use for TMJ or Teeth Grinding?
In our clinical practice, most patients seeking masseter tox for TMF or teeth grinding have received approximately 10 to 50 units per side of Botox (or an equivalent amount of another neuromodulator). Dosing is highly individualized. Some patients have much larger or stronger masseter muscles and have ultimately required higher amounts.
What is the Difference Between Masseter Tox and Jaw Filler?
Patients often ask whether they would benefit more from masseter tox or jawline filler. In our experience, these treatments address different concerns, and the right option depends on what is contributing to the appearance of the jaw and lower face.
We have used masseter tox when the width or fullness of the lower face is related to strong or overactive jaw muscles. In other words, soft tissue bulging between the malar/cheek bone and the jawbone. In patients with enlarged masseter muscles, relaxing the muscle may, over time, soften the width of the lower face. Some patients describe this as their face looking less “square” or heavy through the jaw area.
Jawline filler, on the other hand, is used to add structure and definition to the jaw, specifically adding volume and/or contour on the lower part of the face directly over the mandible bone. It does not reduce muscle size. Jaw filler may be considered for patients who do not have overactive masseter muscles and whose goal is a sharper or more defined lower jawline over the mandible. A common jawline filler is Juvederm Volux.
Is Masseter Tox Permanent?
No, masseter neuromodulator injections are not permanent. Botox, Dysport, Daxxify, Letybo, and Xeomin all work for about 90-120 days based on various clinical trials. Daxxify may last 6-9 months in some patients with glabellar wrinkles, but with masseter injections, it is rare to see any tox last longer than 4 months. In our clinical practice, we have seen similar durations of efficacy when any/all of these products are used for masseter tox.
Can Masseter Tox Affect My Smile, Chewing, Talking, or Cause Jowls?
When neuromodulator injections are placed at the appropriate depth, in the correct location, and at a conservative dose, we have found the risk of affecting smiling, chewing, or speaking is generally low. However, careful patient selection is important.
In some patients, particularly those with age-related skin laxity or early jowling, it has been reported that relaxing the masseter muscle may change how the soft tissues of the lower face are supported. This is why a personalized consultation is essential to determine whether masseter tox is an appropriate option and to minimize the risk of unwanted changes in facial appearance.
[1] Popescu MN, Beiu C, Iliescu CA, et al. Ultrasound-Guided Botulinum Toxin-A Injections into the Masseter Muscle for Both Medical and Aesthetic Purposes. Toxins (Basel). 2024;16(10):413. Published 2024 Sep 24. doi:10.3390/toxins16100413, available at: https://pubmed.ncbi.nlm.nih.gov/39453189/
[2] Fedorowicz Z, van Zuuren EJ, Schoones J. Botulinum toxin for masseter hypertrophy. Cochrane Database Syst Rev. 2013 Sep 9;2013(9):CD007510. doi: 10.1002/14651858.CD007510.pub3. PMID: 24018587; PMCID: PMC7207780, available at: https://pubmed.ncbi.nlm.nih.gov/24018587/
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