Dr. Sam Lam Plastic Surgery Forum

Hello Dr. Lam. I am 50 and in my early 20's my masseter muscles especially the left side started over growing. I remember before this started I was have tmj symtems. For the last 20 years my lower face is pear shaped. It's not really just on the jaw line it almost looks like it's fat in the cheeks but it's muscle. I really dislike the look and wonder if the botox treatment would help. I know people are aware of it and my own mother said to me once "what has happened to your face". I went to an oral surgeon years ago because my Dr. thought I should have it check out. He said he's never seen masseters like that before and didn't really have any answers. Any thoughts or opinion would be appreciatted. Thank you.

obviously, barring the thought of some kind of weird disease or tumor, Botox works tremendously well for hypertrophic masseters. i do one about every week. it also tends to last much longer than regular botox like 9 months or so but takes about a month to show the result. part of the reason for the longevity is the high dose. it is also painless the way that i do it really with no recovery (unless you have a tiny bruise, which is uncommon). i am very precise with treatments as i use caliper measurements to do it. at these high doses you have to be precise. a few years ago when i started doing it without precise measurements, i had some seriously uneven results. i have not seen that for years now.