One treatment that is oftentimes unknown by the general public is Botox used to reduce or slim one’s face, which at the same time can be used to improve TMJ pain, clicking, or locking. Dr. Lam specializes in this type of treatment and has multiple patients fly in every week for this procedure. He wrote a textbook on this subject in 2004 along with multiple shorter manuscripts and has been featured in the New York Times and various news programs regarding his technique. Many patients who have been elsewhere experience a vast difference with Dr. Lam’s method in terms of safety, results, and painlessness.
There are two principal reasons to perform Botox in the lower outer face: to slim the face and to improve TMJ pain. In many cases, individuals seek both benefits, and the procedure will improve both problems simultaneously. Why address the width of the face? Dr. Lam uses this technique in individuals with wide faces to make them look slimmer. In addition, as we age, our lower face starts to become increasingly wider and heavier, taking away from our youth and attractiveness. Botox in the masseter muscle (lower outer face) can help to bring attention back to the eyes and away from the jawline. Even though the results are very powerful, almost no one will detect that you had it done because the slimming effect occurs slowly over 6 weeks. Dr. Lam encourages his in-town patients to return at 6 weeks for photographic review and to show you the benefits of your treatment. Also, a very heavy jawline can masculinize a face, so many women seek not only to look slimmer but also more attractive, as Botox can be used to soften facial features. Interestingly, about 30% of Dr. Lam’s patients are men who suffer from TMJ and also who have a heavy and wide lower face that they would like improved.
Botox on the sides of the face in the region of the masseter muscle is undertaken for two principal reasons: TMJ (temporo-mandibular joint) pain and facial slimming. Dr. Lam uses two different ways to manage TMJ/facial pain as compared with for facial slimming. TMJ pain can lead to debilitating problems of facial pain that Dr. Lam uses a very targeted method to improve with near instant results. For Botox facial slimming he applies a highly concentrated dose with precision to improve the facial shape. Sometimes patients have both problems and he may perform a combined technique to address both the pain and the facial shape.
For facial slimming, Dr. Lam’s technique is truly unique in its accuracy and painlessness. Because this is a higher dose of Botox, it is important that the treatment be performed with absolute precision. When you undergo treatment with Dr. Lam you will experience how elaborate and precise his marking procedure is to ensure an accurate result. His first two years of practice he encountered results that were far from excellent but in the past 13 years has not seen these kind of aberrant outcomes due to significant clinical experience and precise application of Botox. In addition, when people have received treatment elsewhere they are usually quite surprised that Dr. Lam’s vibratory technique is absolutely painless. You should not be able to feel any needles injected even with no numbing cream of any kind. It also takes a few seconds to perform and typically has no discernible recovery period. You should notice visible slimming but it takes a few weeks to see the full result.
Dr. Lam has invented a unique technique to manage TMJ pain, which can lead to headaches, clicking, popping, pain, and facial widening. Many patients’ symptoms are so severe that their daily quality of life is greatly impacted. Although facial slimming takes a few weeks to be evident, many TMJ sufferers feel relief very quickly within a few seconds of the injection. Obviously, the treatment could also benefit dental health since the strain from clenching and grinding can be offset by weakening the muscle or by targeting the tendons that Dr. Lam manages.
It is extremely important to inject Botox accurately at the right level. Going too far forward can affect one’s speech, as a Korean paper has reported. In addition, placing Botox in the precise level and distribution is critical for optimal results. As far as facial slimming is concerned, Dr. Lam injects Botox at the maximal curvature of the muscle, where there is an interface of three sleeves of the masseter muscle. This area has the maximal pull on the bone that causes both muscle hypertrophy (excessive muscle growth) and related bone hypertrophy (excessive bone growth). Why bone hypertrophy? When the muscle pulls on the bone, the bone also enlarges as a consequence making the entire complex enlarged.
The parotid gland is also adjacent and overlies these structures and can also be contoured with Botox. The parotid gland produces saliva but Dr. Lam has never observed any dry mouth in individuals who undergo this procedure. The parotid gland can also account for facial widening and Dr. Lam at times targets elements of facial width by reducing the corresponding area of parotid excess. He can do so safely and effectively and can discuss with you how this part of the procedure applies to you.
A question has arisen whether bone reduction surgery is a viable alternative. In Dr. Lam’s opinion, the problem with this surgery, which he trained to do in Korea, is too invasive, having increased risk and prolonged recovery. In addition, cutting the jawbone can lead to a jaw shape that looks like an animal, i.e., unnatural in appearance. In addition, it fails to address the parotid and the masseter muscle sufficiently in Dr. Lam’s opinion. Dr. Lam has injected patients with Botox who already had undergone bony reduction elsewhere because their face did not achieve what they desired.
The natural question is how safe is this procedure? In Dr. Lam’s hands, it is very safe. He has been performing this procedure for over 15 years and has not had any long-term problems with it, only long-term successes where TMJ and facial slimming have progressively improved over time. That then prompts the question of how long it lasts. Typically, the first treatment lasts approximately 6 months. If one is grinding and clenching then it may not last longer than that period unless the habit is broken (which Botox can assist in), but if there is no TMJ component, the result can oftentimes last a year or longer. Dr. Lam encourages everyone to return in 6 months for an additional treatment followed by 9 months after the second treatment, then progressively less frequently. In even chronic TMJ sufferers, Dr. Lam has observed progressive lengthening in the time interval required for Botox jaw reduction but he cannot promise you how long it will last. Some reports suggest that this treatment can be permanent after a few rounds but Dr. Lam cannot make this promise. However, he does believe that multiple treatments can lead to increasing longevity in most individuals.
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FAQs
For TMJ/facial pain, how is Dr. Lam’s technique different from other doctors?
Dr. Lam has been injecting Botox for masseter pain and fullness now for over 20 years. He has invented a unique technique that currently no one else in the world performs. His method provides instant relief of TMJ pain that can lead to profound relaxation, anxiety reduction, better sleep, dental protection, and pain reduction almost immediately. The method he uses may be best described as a trigger point release. It is an entirely different technique than what he uses to slim a face. In fact, this method will not slim your face but only manage pain, tightness, clicking, tenderness, anxiety, etc. As mentioned, the pain relief is instant and the method he uses requires that there is slight pain increase followed immediately by pain relief. This unique method of Botox for pain truly creates profound improvement in tension, headaches, etc.
If I have both TMJ pain and also a wide face, which method will Dr. Lam use for my face?
Dr. Lam will oftentimes combine it with the facial slimming method, which can also help with pain but not to the same degree. If you have a very wide face with a very strong muscle, then Dr. Lam may recommend the other method or combine it with the pain relief method to achieve optimal outcomes. With a very strong muscle, the tendon release method may be insufficient to achieve full relief. Only a consultation with Dr. Lam will help you decide which course of action will be the preferred way to go for you.
What are the complications with Botox treatments in the masseter region?
Fortunately, there are no long-term complications with Botox in the masseter region. However, in about 5% of cases with the slimming technique there can be some bulging in areas when someone bites down. This typically goes away without intervention in about 4-8 weeks. However, Dr. Lam also can easily manage the situation at no extra charge with a simple injection into the bulge. In about 1 to 2% of the time, the smile can also be crooked usually minimally so and that also goes away in 4 to 8 weeks. That can happen with either technique but is very uncommon and completely temporary and short-lived. With pain treatments, sometimes there are residual areas of pain that show up after a week and may need additional injections. All touchups in the first month are undertaken at no extra charge.
Will treatment cause me to have larger jowls?
This should not be the case. However, someone that already has jowls and a wider face may notice that their jowls are bigger only because the outer face has relatively shrunk in size. If that is the case, usually Dr. Lam will advise you against the treatment or combine the treatment with fillers in the jowl region to soften it. In short, the treatment should not make jowls actually larger in size.
How often do I need to see Dr. Lam for more treatments?
Usually, the treatment is undertaken every 6 months, especially for jaw slimming. However, for TMJ pain, especially severe cases, at times you may need every 3 months until the pain starts to be under control and you can go progressively at longer intervals. Sometimes, someone can get a treatment starting at every 6 months, whereas other times it may take one round at 3 months before going to every 6 months. Sometimes after 3 to 4 rounds you may be able to go even longer and some patients only now see Dr. Lam every 9 to 12 months. Very severe patients may even have to see Dr. Lam every 2 to 3 months initially before starting to see him less often. Everyone is different, but the key is not to wait until the pain is fully back but only starting to become a problem in order to have the best chance of lengthening your interval.
Does Dr. Lam take insurance for these treatments?
No, but the method Dr. Lam performs no one in the world does and the level of release and improvement are truly unique.
His technique is great and i never have pain when he does my fillers and botox.
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For a consultation with Dr. Lam regarding whether Botox jaw slimming would work for you, please email us at info@lamfacialplastics.com or call 972.312.8105.