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

Turns out, stress has a way of presenting itself 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. 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 millions of views.

At the same time, there's an entirely different group of people who claim the treatment can cause unexpected bulging and/or jowling—but we'll get to that later.

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.

• 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.
• Margarita Lolis, MD, is a board-certified dermatologist in New Jersey.

• 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?
• We tried masseter Botox
• Masseter Botox: the TL;DR

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.

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.

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 normally. "There are many muscles that 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).

First, your doctor will examine you to make sure you're a good candidate for masseter Botox. In other words, they need to confirm your masseter muscle is enlarged or you have TMJ_**, and you’ll likely need to have a dental exam to determine this~~.** You'll want to do some research before choosing your provider, 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 the doctor is the right fit for you. You’ll probably also need to have a dental exam to determine if you're a candidate. (If you’re pregnant or breastfeeding, you should avoid Botox completely.)

Your doctor will then examine your jaw in greater detail. They may ask you to clench your teeth, for example, says Dr. Marchbein. During this exam, she says 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.

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 afterward,” says Dr. Soni. "I just say avoid heavy drinking the same night to minimize any chance of bruising, but that's literally it."

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, pain or discomfort, and bruising at the injection site are fairly common.

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

As for the potential development of jowls—which currently has TikTok in a frenzy—it's theoretically possible, but low risk, says Margarita Lolis, MD, a board-certified dermatologist in New Jersey. "Bone, muscle, ligaments, fat pads, and fibrous tissue all provide structural support to the lower face, and as we age, factors such as bone resorption, fat atrophy and displacement, ligament weakening, and loss of collagen can all lead to jowling," says Dr. Lolis. "So, theoretically, diminishing the size of the masseter can potentially contribute to jowling."

However, she points out that the masseter is a large muscle, and if the appropriate amount of toxin is injected, it will continue to be large enough to provide structural support. Therefore, with enough support, the chance for jowling is low.

Relatively often, videos pop up on social media showing extremes of incorrectly done procedures. In a way, it’s a good reminder that these are medical procedures and that one should always approach with caution. It’s also a reminder that it’s MOST important to go in someone who is trained in these complex procedures and has an idea of the anatomy. You can never compromise your health or well-being for a quick fix and so hopefully this is a good reminder to take your time and find someone you trust.

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.

Recently, Allure's editor in chief Jessica Cruel got masseter Botox from Michelle Henry, MD, a board-certified dermatologist in New York City. She was looking for a way to stop clenching her jaw—and the pain she experienced along with it. “I was waking up with headaches and a sore jaw,” says Cruel. “My dentist, psychiatrist, facialist, and dermatologist all recommended masseter Botox to help strengthen my overdeveloped jaw muscles.” Dr. Henry gave Cruel 16 units of Xeomin in each side of her face, and then eight units in each temple, where clenching can occur as well.

“I’m not waking up with a sore jaw anymore,” says Cruel, who got masseter Botox about a month ago. The treatment also subtly changed the shape of her jawline, to more of a heart-like shape, adds Cruel. (Whether or not masseter Botox changes the look of the jaw is dependent on one's facial anatomy and treatment plan, though, so Cruel's experience may not hold true for everyone.)

Just because masseter Botox is commonly performed, that doesn't mean it's for everyone. Dr. Marchbein says that the treatment is 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:

• What Is Daxxify, and Why Would I Want to Inject It in My Face?
• Black Americans Are Getting Botox More Than Ever
• What Is Hair Botox and Why Is Everyone Talking About It?

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