Masseteric Muscle Disinsertion from Jaw Angle Implants

Q: Dr. Eppley, Ive had jaw angle lengthening implant surgery 5 weeks ago. But the masseter muscle didn’t come down with the lower edge ofthe implant. So I had Botox yesterday in order to downsize the relatively large upper muscle. But I am now really regreting that this was a bad idea because I heard this type of surgery needs at least 3 months of recovery time.

Can these Botox injections make my final look worse than it should be? And if so what can I do from now?I would have had Botox anyway but it was too premature.

A: You are correct in that one should wait a full three months after any facial implant surgery to have a full and accurate appraisal of the final result. Doing Botox at 5 weeks after surgery was not only premature but you ran the risk of inadvertently inoculating the implants and causing an infection. That alone should have given everyone pause for reflection on the merits of these early injections.

While Botox is a valid treatment for masseteric muscle disinsertion, waiting for the full recovery and then evaluating the merits of Botox injections, masseteric muscle resuspension or a change in the jaw angle implant style could be more prudently done.

Dr. Barry Eppley

Indianapolis, Indiana