Factors Associated With Paradoxical Masseteric Bulging After Botulinum Toxin Injection for Masseter Hypertrophy: A Retrospective Analysis

Key Points

• This analysis aims to identify factors related to paradoxical masseteric bulging after botulinum toxin injections for masseter hypertrophy.
• Retrospective analysis of patients undergoing botulinum toxin injection for masseter hypertrophy.
• Utilized preoperative ultrasound assessment for masseter and DIT characteristics.
• Employed individualized layered injection with intraoperative tactile feedback.
• Preoperative ultrasound assessment effectively mitigated the risk of paradoxical masseteric bulging.
• Ultrasound-guided supplementary injections were preferred for managing bulging.
• Individualized layered injection techniques showed positive outcomes.