A Woman On TikTok Is Sharing How Dysport Injections For TMJ Pain Botched Her Smile
"The width of my mouth started shortening. I could see less and less of my teeth when I would smile."
This is Montanna Morris from Florida, and recently she shared on TikTok how receiving Dysport facial injections for her TMJ (temporomandibular joint) pain botched her smile.

Montanna said, "My doctor had prescribed me muscle relaxers before, but that didn’t help, so she recommended Botox as an option before major jaw surgery. The injector told me I would have final results within a week or two, but my face was already freezing within four days — so I knew it was going to be bad."
She continued, "The width of my mouth started shortening. I could see less and less of my teeth when I would smile — that’s the first thing I noticed. Then my dimples almost completely went away. My TMJ is better — my jaw did unlock soon after treatment and locks up a lot less now, but I surprisingly have more pain than before. From the paralysis, I’ve had quite a bit of muscle atrophy, so chewing certain things is more difficult than before."

Montanna said she received treatment on Jan. 21, and while she's seen some improvement, she feels as if recovery has slowed. When asked what went wrong, she said, "They were running a discount on Dysport, which is just a different brand than Botox, but the unit measurements are different — so I decided to go with that. They told me that 1 unit of Botox was equivalent to 3 units of Dysport. I had only agreed to 15 units of Botox in each masseter muscle, but the injector didn’t draw the proper amount when converting the numbers for Dysport."

She added, "I never got to speak to the original injector again, but when I went back for a follow-up, a different injector told me that on top of over-injecting, it was also likely she injected in the wrong area. The med spa unfortunately didn’t have the best attitude at first and tried to act like this just happens sometimes and 'a lot people don’t mind it,' but I ended up demanding a full refund — and they did follow through with that."
To get a professional opinion, BuzzFeed talked to New York City–based facial plastic surgeon Dr. Gary Linkov, who practices at City Facial Plastics. Linkov told BuzzFeed, "I hear stories like this all the time. A patient comes in telling me that they had this done and their smile was impacted, and now they are scared to have it done again. Improper placement AND improper neurotoxin selection is why this can happen. Dysport is known to diffuse more than some of the other options, like Botox. Therefore, Dysport SHOULD NOT be used in the masseter muscle for TMJ. Botox is the better option. In terms of placement, many providers will feel the masseter muscle and inject the thickest part — but that ends up being too close in vicinity to the risorius muscle, which is the main culprit in smile distortion after masseter injections."

Masseter (left, bottom) and risorius muscles
Luckily, Linkov told us, there is light at the end of the tunnel. "It generally takes three to four months for the effects of a neurotoxin to wear off, regardless of which type was used," he said. "Since her injections were two months ago, in the next month or two, things will go back to normal."

As for receiving treatment in the future, Linkov added, "Take the time to find a knowledgeable injector who fully understands facial anatomy and the differences between the various types of neurotoxins. Inquire about their past experience. A good way to gauge experience is to see if they normally inject the masseter muscle for cosmetic lower-face slimming. If they do, there is a good chance they can safely inject that muscle for you for TMJ purposes."
"I’ve learned that this happens quite often to people but hardly anyone speaks on it, most likely because it is an embarrassing thing to go through," Montanna told BuzzFeed. "I can proudly say that I’ve been a very confident person my entire life, but losing my smile has affected my personality more than I ever could have imagined. The good thing is that this is only temporary. Eventually my smile will be back to normal! So far, I’ve had some really sincere thank-you messages for spreading awareness of what could possibly happen, which makes me feel okay knowing so many people have now seen my face like this!"
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