Standing Appointment is our review series that investigates the best new and notable cosmetic procedures in the aesthetics space and determines whether or not they are worth trying for yourself. This week, a writer tests out masseter Botox.
I have been living with migraines since the time I got my first period — which, thanks to my family’s stellar genetics, was right around the age of nine. The next two decades contained a series of stops and starts with treatments, with certain solutions working for a while before unexpectedly quitting for no reason. Now, at 31, I’ve figured out a routine that mostly keeps me migraine-free: Non-hormonal birth control, regular acupuncture appointments, and limiting myself to one glass of wine whenever I choose to partake in booze. It’s not sexy, but for the most part, it keeps me without an aching head.
Since about last summer, though, I’ve been waking up with headaches that feel like something large and elephant-like is sitting on my head. For a while, I thought it was morning dehydration. But after my dentist flagged the fact that my back teeth looked a little worn down, the true culprit became clear: I’ve been grinding my teeth, both when I snooze and when I’m stressed out. Which, given the state of the world at the moment, is pretty much 24/7.
And I’m not alone. “More patients than ever are complaining of jaw pain, TMJ, and headaches,” says Laura Dyer, a PA-C in cosmetic dermatology in NYC. “I think the past two years have been very stressful on most people, and many of them are carrying the stress in their masseter muscles and have a tense overall lower face.”
What Are The Benefits Of Masseter Botox?
For those who don’t study anatomy, the masseter is a triangle-shaped muscle that extends from under your cheekbone to below your jaw. It helps you chew, but it’s also the muscle that gets activated whenever you hold tension in your jaw. So people who tend to grind their teeth or hold tension in their jaw usually have an overdeveloped masseter muscle, which can result in a squared-off look to their jawline. It’s a never-ending cycle, though: The more you clench or grind your teeth, the more overdeveloped your masseter muscle will be, which will lead to increased clenching or grinding.
My masseter muscles, it turns out, were incredibly overdeveloped. (You can feel them when you clench your teeth and rub the area of your face where your jaw meets the rest of your skull.) That meant I was likely over-grinding my teeth, which was probably the reason for my headaches.
The good news is that, like most muscles, the masseter will weaken the less you use it. That’s where a neuromodulator like Botox comes in. By injecting the jaw muscle with Botox, you temporarily paralyze the muscle so it can’t contract, which in turn, weakens it and reduces the size. This can have many benefits. “Some people [use] Botox [in] this area to help decrease jaw clenching, the relaxation of this muscle can help with TMJ, teeth grinding, and headaches,” Dyer says. “Others inject this area to achieve a slimmer jawline or V shape of the lower face.” (Heads up — this is an off-label use for Botox, which means it isn’t FDA-approved, but most cosmetic derms will still offer the treatment.)
As I’ve already given Botox a shot to help with my migraines, I was curious about how it might help my morning headaches. I went to Dyer for the treatment, which she assured me would be over quickly.
What Goes Down In A Masseter Botox Appointment?
She wasn’t kidding. The longest part of my appointment was waiting for the numbing agent to kick in, which took about 10 minutes. She swiped it along my jawline, waited, and then gave me three small injections along my jaw on both sides. (I usually get about 6-7 injections in my forehead during those procedures, so it’s pretty equitable, although depending on where you go for your appointment, masseter Botox can be more expensive.) Thanks to being numbed, I didn’t feel a thing, but Dyer says that you may feel a little pain or pressure if you opt out of topical anesthesia. Since the muscle is larger, the injection does have to go slightly deeper than your typical prick on your forehead, which may explain the pressure.
Unlike Botox for fine lines, the results from masseter treatments can take a little longer to show up. “The Botox will kick in between seven to 14 days, but it can take up to three months for you to see any change in the shape of your jawline,” Dyer says. This is because the muscle on the jaw is so much bigger and covers a larger area, so it takes longer for the Botox to work its way in. I started to feel the difference after about a week. One morning I woke up with my typical pressure headache, and the next day I didn’t. It was a revelation. I felt I had more energy, which makes sense since, according to Mayo Clinic, grinding your teeth while you snooze can result in a lower sleep quality.
A month after my initial treatment, I saw Dyer for a follow-up, where she gave me three more injections on either side of my jaw. (Ever the overachiever, my jaw muscles were still on the overdeveloped side.) “Common side effects include temporary redness, soreness, and occasional bruising at the injection site,” Dyer explained to me. I had dinner plans with friends after each appointment, and none of them noticed that I’d been to the dermatologist. That said, my jaw was a little sore for two days after my injections, especially after the second round.
The Results Of Getting Masseter Botox — So Far
It’s been about three weeks since my second meeting with Dyer, and I’m officially hooked. I don’t wake up with headaches anymore, and my sleep schedule has gotten better. And while I don’t see a huge difference in my jawline, to me, it does seem slightly more contoured and less squared-off.
The biggest change, though, is that I haven’t caught myself clenching my jaw nearly as much as I did in the past. Usually around 2 p.m., I’d notice that the region was bothering me, or I’d start to get a low-grade headache. Those symptoms, I’d realize, were because I’d been clenching and didn’t realize it. Because my muscles are now weaker, I don’t find myself clenching as often or as hard, and when I do notice it, it feels like I’m actually able to relax the tension.
Results will last from three to four months, according to Dyer, and it’s important to space your appointments out so as to not weaken the muscle too much. (You do need it to chew, after all.) Dyer did mention that, after a while, most of her clients only wind up coming in once every six months, because the muscles in your jaw do wind up acclimating to their new, weakened state.
Whether it’s every six months or every four, I plan to make masseter Botox a part of my regular beauty maintenance. Sure, a slimmer jaw is a nice perk, but not waking up with headaches? You can take all of my money if you promise me that.