This is a medical procedure with genuine risks, and your director goes through them before you consent to anything. Small bruises at the puncture points are the commonest event, along with pinpoint redness, a little swelling and, for some patients, a headache in the first day or two. A deep ache in the jaw for a day is not unusual, since the needle travels into muscle.
The complications specific to this area are worth stating by name. Chewing weakness is the leading one: with the masseter dialled down, steak, hard bread, dried squid and anything else requiring sustained force can feel like hard work for a period, and a few patients notice they tire while eating a long meal. Smile asymmetry is the second, and it happens when the toxin spreads forward into the muscles that lift the corner of the mouth, producing a crooked smile or a lip that behaves differently on one side. Uneven results between the left and right jaw are possible where one side was already stronger. Some patients see a hollow appear at the cheek as the muscle reduces, which flatters a full face and does not flatter a thin one. Paradoxical bulging, where a small part of the muscle stands out on clenching while the rest relaxes, is described in the literature and shows up occasionally. Very rarely the muscle barely responds.
Most of these settle as the effect wears off, and a temporary problem is still a real one while it lasts, since a lopsided smile can sit with you for weeks. Stay upright for several hours, keep massage and heat off the jaw angles for the period your director specifies, and contact the clinic if your smile changes shape, if a bruise keeps growing, or if pain or redness increases after the first day. A resident medical director is on site throughout opening hours. Patients who are considering toxin for sweating should read the separate cautions on the underarm sweat botox page, since the areas differ.