LAM FACIAL PLASTICS

Does it make a difference whether your muscle is relaxed or contracted when the botox is inserted? my friend in another state just got her jaw done yesterday and she says that a huge painful lump has developed at one of the injection sites. she said she forgot to relax her muscles when the dr told her to stop biting down. do you think this caused the problem? also, what are the chances that a painful lump will result in any given injection site, and how long would it last? is it a serious complication? thanks

she got a hematoma. that is why i pre-ice with a special icepack for 1 minute before i inject and i use tiny needles. without the ice, it sounds as if she got a hematoma (blood clot). it will take a while for that to resorb. fortunately, i have not seen one of those in years since i have done my icing technique. it should not hurt at all after injection.
best,
sml

I have another question regarding botox resistence
with jaw reduction, does the large amt used contribute to the possibility of botox resistence?
also, would massaging the jaw area after treatment contribute to botox leaking into the systemic circulation?
how does one notice botox resistence? delayed onset of muscle weakening?

first, resistance is very rare today especially for cosmetic doses including the masseter. when using several bottles for neck dystonias, you have a higher risk. however, since the reduction of the blocking protein in 1998, there has been a sixfold decrease in resistance in those patients receiving massively high doses. in one study published in 2003, they found 4 of 42 patients who used the pre-1998 formulation had resistance (9%) when treating cervical dystonias compared with 0 of 119 using the current formulation that reduces blocking antibodies by 1/5th.

a hematoma? that sounds very serious. well it doesn't really look like a lump, per se. When i saw her face it just looked like her jaw muscles immediately came back full force stronger than before. it is more of a swollen appearance than that of a lump. is that what a hematoma looks like? if so, how long before such things resorb back into the body?

if it is just swollen and not a lump then it sounds more like just swelling than a hematoma. I really should refrain from further commentary and you should ask your doctor because in my hands I do not see these outcomes in my patients.